{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:58:14Z","timestamp":1787590694130,"version":"build-2736575974"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,7,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The transition to dialysis period carries a substantial increased cardiovascular risk in patients with chronic kidney disease. Despite this, alterations in cardiovascular functional capacity during this transition are largely unknown. The present study therefore sought to assess ventilatory exercise response measures in patients within 1\u2009year of initiating dialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We conducted a cross\u2010sectional study of 241 patients with chronic kidney disease stage 5 from the CAPER (Cardiopulmonary Exercise Testing in Renal Failure) study and from the intradialytic low\u2010frequency electrical muscle stimulation pilot randomized controlled trial cohorts. Patients underwent cardiopulmonary exercise testing and echocardiography. Of the 241 patients (age, 48.9 [15.0] years; 154 [63.9%] men), 42 were predialytic (mean estimated glomerular filtration rate, 14\u2009mL\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b71.73 m\n                      <jats:sup>\u22122<\/jats:sup>\n                      ), 54 had a dialysis vintage \u226412\u2009months, and 145 had a dialysis vintage &gt;12\u2009months. Dialysis vintage \u226412\u2009months exhibited a significantly impaired cardiovascular functional capacity, as assessed by oxygen uptake at peak exercise (18.7 [5.8] mL\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) compared with predialysis (22.7 [5.2] mL\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      ;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Dialysis vintage \u226412\u2009months also exhibited reduced peak workload, impaired peak heart rate, reduced circulatory power, and increased left ventricular mass index (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05 for all) compared with predialysis. After excluding those with prior kidney transplant, dialysis vintage &gt;12\u2009months exhibited a lower oxygen uptake at peak exercise (17.0 [4.9] mL\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) compared with dialysis vintage \u226412\u2009months (18.9 [5.9] mL\u00b7min\n                      <jats:sup>\u22121<\/jats:sup>\n                      \u00b7kg\n                      <jats:sup>\u22121<\/jats:sup>\n                      ;\n                      <jats:italic>P<\/jats:italic>\n                      =0.033).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Initiating dialysis is associated with a significant impairment in oxygen uptake at peak exercise and overall decrements in ventilatory and hemodynamic exercise responses that predispose patients to functional dependence. The magnitude of these changes is comparable to the differences between low\u2010risk New York Heart Association class I and higher\u2010risk New York Heart Association class II to IV heart failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.025656","type":"journal-article","created":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T07:18:39Z","timestamp":1657005519000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Initiation of Dialysis Is Associated With Impaired Cardiovascular Functional Capacity"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7008-763X","authenticated-orcid":false,"given":"Eliott","family":"Arroyo","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Medicine Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3996-2448","authenticated-orcid":false,"given":"Peter E.","family":"Umukoro","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Medicine Indiana University School of Medicine Indianapolis IN"},{"name":"Department of Nephrology Hendricks Regional Health Danville IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather N.","family":"Burney","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7024-7103","authenticated-orcid":false,"given":"Yang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen A.","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Jawad","family":"Sher","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Medicine Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzong\u2010shi","family":"Lu","sequence":"additional","affiliation":[{"name":"Renal Division Department of Medicine Brigham and Women\u2019s Hospital and Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M.","family":"Moe","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Medicine Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjani","family":"Moorthi","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Medicine Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Coggan","sequence":"additional","affiliation":[{"name":"Department of Kinesiology Indiana University\u2013Purdue University Indianapolis Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8963-9107","authenticated-orcid":false,"given":"Gordon","family":"McGregor","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Hospital Coventry and Warwickshire National Health Service Trust Coventry United Kingdom"},{"name":"Department of Cardiology University Hospital Coventry and Warwickshire National Health Service Trust Coventry United Kingdom"},{"name":"Centre for Sport, Exercise, and Life Sciences Coventry University Coventry United Kingdom"},{"name":"Warwick Clinical Trials Unit Warwick Medical School University of Warwick Coventry United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas F.","family":"Hiemstra","sequence":"additional","affiliation":[{"name":"Cambridge Clinical Trials Unit Cambridge University Hospitals National Health Service Foundation Trust Cambridge United Kingdom"},{"name":"School of Clinical Medicine University of Cambridge Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Zehnder","sequence":"additional","affiliation":[{"name":"Department of Nephrology North Cumbria University Hospital National Health Service Trust Carlisle United Kingdom"},{"name":"Department of Acute Medicine North Cumbria University Hospital National Health Service Trust Carlisle United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7178-2183","authenticated-orcid":false,"given":"Kenneth","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Nephrology and 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