Investigating exercise responses in patients with chronic kidney disease

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This project aims to explore the mechanisms and potential therapies related to exercise capacity in individuals with chronic kidney disease (CKD). It focuses on understanding the neurovascular responses during exercise and how they contribute to exercise intolerance in CKD patients. The study will involve interventions such as sodium bicarbonate and exercise training, comparing responses in CKD patients to matched controls without kidney disease. By elucidating the underlying mechanisms of exercise dysfunction, the research seeks to identify new therapeutic strategies to improve physical capacity in these patients.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* patients with CKD (Stages III and IV), kidney transplant recipients with varying degrees of kidney function, or persons without kidney disease as matched study controls
* sedentary and do not regularly exercise (defined as exercising \< 20 minutes twice per week)
* CKD patients must have stable renal function (no greater than a decline of estimated glomerular filtration (eGFR) of 1 cc/min/1.73 m2 per month over the prior 6 months) and baseline serum bicarbonate 22-24 mmol/L
* comorbid hypertension

Exclusion Criteria:

* severe CKD (eGFR\<15 cc/min)
* metabolic alkalosis
* current treatment with bicarbonate
* ongoing drug or alcohol abuse
* diabetic neuropathy, autonomic dysfunction
* any serious disease that might influence survival
* anemia with hemoglobin \<10 g/dL
* clinical evidence of heart failure
* volume overload or ejection fraction below 45%
* symptomatic heart disease by EKG, stress test, and/or history
* treatment with central α-agonists (clonidine)
* myocardial infarction or cerebrovascular accident within the past six months
* uncontrolled hypertension (BP\>170/100 mm Hg)
* low BP\<100/50 mm Hg
* surgery within the past 3 months
* pregnancy or plans to become pregnant
* inability to exercise on a stationary bicycle
* contraindication to temporary withdrawal of α- and β-blockers
* peripheral arterial disease
* class 3 obesity (BMI\>40)
* hypo- or hyperkalemia (K\<3.5meq/L, K\>5.0 meq/L)
* current use of immunosuppressive medications (including but not limited to steroids, cyclophosphamide, calcineurin inhibitors, mycophenolate, biologics, methotrexate, etc)
* arteriovenous (AV) fistula/graft
* any contraindication to MR scanning including cardiac pacemaker, cochlear implants, neurostimulators, implanted devices with metal, any metal in the body that could pose a hazard during scanning, history of claustrophobia

Where it's running

• Emory Clinic
  Atlanta, Georgia, United States Recruiting
• Atlanta VA Medical Center
  Decatur, Georgia, United States Recruiting

Study contacts

• Principal investigator: Jeanie Park, MD — Emory University
• Study coordinator: Dana DaCosta
• Email: drdacos@emory.edu
• Phone: 404-727-7762

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.