Impaired K+ regulation contributes to exercise limitation in end-stage renal failure

Sangkabutra, Termboon, Crankshaw, David P., Schneider, Claudia, Fraser, Steve F., Sostaric, Simon, Mason, Kim, Burge, Caroline M., Skinner, Sandford L., McMahon, Lawrence P. and McKenna, Michael J. 2003, Impaired K+ regulation contributes to exercise limitation in end-stage renal failure, Kidney international, vol. 63, no. 1, pp. 283-290, doi: 10.1046/j.1523-1755.2003.00739.x.

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Title Impaired K+ regulation contributes to exercise limitation in end-stage renal failure
Author(s) Sangkabutra, Termboon
Crankshaw, David P.
Schneider, Claudia
Fraser, Steve F.ORCID iD for Fraser, Steve F.
Sostaric, Simon
Mason, Kim
Burge, Caroline M.
Skinner, Sandford L.
McMahon, Lawrence P.
McKenna, Michael J.
Journal name Kidney international
Volume number 63
Issue number 1
Start page 283
End page 290
Total pages 8
Publisher Nature Publishing Group
Place of publication London, England
Publication date 2003
ISSN 0085-2538
Summary Background

Patients with end-stage renal failure (ESRF) exhibit grossly impaired maximal exercise performance. This study investigated whether K+ regulation during exercise is impaired in ESRF and whether this is related to reduced exercise performance.


Nine stable hemodialysis patients and eight controls (CON) performed incremental cycling exercise to volitional fatigue, with measurement of peak oxygen consumption (VdotO2 peak). Arterial blood was sampled during and following exercise and analyzed for plasma [K+] (PK).


The VdotO2 peak was approximately 44% less in ESRF than in CON (P < 0.001), whereas peak exercise PK was greater (7.23 plusminus 0.38 vs. 6.23 plusminus 0.14 mmol dot L-1, respectively, P < 0.001). In ESRF, the rate of rise in PK during exercise was twofold greater (0.43 plusminus 0.05 vs. 0.23 plusminus 0.03 mmol dot L-1dotmin-1, P < 0.005) and the ratio of rise in PK relative to work performed was 3.7-fold higher (90.1 plusminus 13.5 vs. 24.7 plusminus 3.3 nmol dot L-1dot J-1, P < 0.001). A strong inverse relationship was found between VdotO2 peak and the DeltaPKdot work-1 ratio (r = -0.80, N = 17, P < 0.001).


Patients with ESRF exhibit grossly impaired extrarenal K+ regulation during exercise, demonstrated by an excessive rise in PK relative to work performed. We further show that K+ regulation during exercise was correlated with aerobic exercise performance. These results suggest that disturbed K+ regulation in ESRF contributes to early muscle fatigue during exercise, thus causing reduced exercise performance.
Language eng
DOI 10.1046/j.1523-1755.2003.00739.x
Field of Research 110602 Exercise Physiology
110312 Nephrology and Urology
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2003, International Society of Nephrology
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Document type: Journal Article
Collection: School of Exercise and Nutrition Sciences
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