{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:15:58Z","timestamp":1791598558559,"version":"4.3.4"},"reference-count":61,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","funder":[{"name":"European Joint Transnational Call","award":["JTC-THCS 2024"],"award-info":[{"award-number":["JTC-THCS 2024"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Children with CKD exhibit markedly lower cardiopulmonary fitness with an absolute maximal oxygen uptake deficit of 10 ml\/kg per minute compared with reference values.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>More than half of the patients show impaired fitness as early as CKD stage 3, highlighting early functional vulnerability.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Maximal oxygen uptake is independently associated with modifiable parameters commonly targeted by rehabilitation, supporting tailored intervention strategies.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Children with CKD are at high cardiovascular risk, yet cardiopulmonary fitness is rarely assessed in routine care. Maximal oxygen uptake (VO\n                      <jats:sub>2<\/jats:sub>\n                      max) is a powerful prognostic marker, and\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      -score\u2013based evaluations may improve early risk stratification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective multicenter study, children aged 6\u201317 years with CKD stages 2\u20135 (Kidney Disease Improving Global Outcome) underwent standardized cardiopulmonary exercise testing (CPET). VO\n                      <jats:sub>2<\/jats:sub>\n                      max was expressed as\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      -scores using contemporary pediatric reference values. Impaired fitness was defined as VO\n                      <jats:sub>2<\/jats:sub>\n                      max\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      -score &lt;\u20131.64. Multivariable linear regression was used to identify independent determinants of VO\n                      <jats:sub>2<\/jats:sub>\n                      max.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 88 enrolled patients (mean age 12\u00b14 years, 67% male), 77 completed a valid CPET. Mean VO\n                      <jats:sub>2<\/jats:sub>\n                      max\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      -score was \u22121.8\u00b12.1, corresponding to 33.5\u00b19.2 ml\/kg per minute, that is, an absolute lowering of approximately 10 ml\/kg per minute compared with age-matched and sex-matched reference values. Overall, 57% had impaired fitness. VO\n                      <jats:sub>2<\/jats:sub>\n                      max was progressively lower across higher CKD stages (\n                      <jats:italic toggle=\"yes\">P &lt; 0.001<\/jats:italic>\n                      ). In multivariable analysis, higher VO\n                      <jats:sub>2<\/jats:sub>\n                      max was independently associated with higher hemoglobin concentration, better pulmonary function (forced expiratory volume in 1 s), better ventilatory efficiency (VE\/VCO\n                      <jats:sub>2<\/jats:sub>\n                      slope), and higher ventilatory anaerobic threshold, explaining 77% of VO\n                      <jats:sub>2<\/jats:sub>\n                      max variability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Cardiopulmonary fitness is markedly lower in children with CKD, with a clear stage-dependent decline that is already evident at early disease stages. The magnitude of VO\n                      <jats:sub>2<\/jats:sub>\n                      max impairment is substantial and related to potentially modifiable clinical and functional factors, supporting early CPET-based screening and the development of targeted, multidisciplinary rehabilitation in pediatric CKD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial registry name and registration number:<\/jats:title>\n                    <jats:p>Clinicaltrials.gov identifier NCT04897672 and Montpellier University Hospital Institutional Review Board (IRB 202100852).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000001113","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T16:00:56Z","timestamp":1784736056000},"page":"1719-1732","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Early and Stage-Dependent Cardiopulmonary Fitness Impairment in Pediatric CKD"],"prefix":"10.2215","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3741-0498","authenticated-orcid":false,"given":"Oscar","family":"Werner","sequence":"first","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"},{"name":"Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes University, CHU Nantes, Nantes, France"},{"name":"IHU Liryc, Electrophysiology and Heart Modelling Institute, INSERM U1045, University of Bordeaux, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8857-7100","authenticated-orcid":false,"given":"Marc","family":"Fila","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"},{"name":"INSERM U1191, URMS 5203, CNRS, Institut de G\u00e9nomique Fonctionnelle, University of Montpellier, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8358-5320","authenticated-orcid":false,"given":"Fanchon","family":"Herman","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Department, University Hospital, University of Montpellier, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Audi\u00e9","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modelling Institute, INSERM U1045, University of Bordeaux, Bordeaux, France"},{"name":"Department of Pediatric and Adult Congenital Cardiology, M3C National Reference Center, Bordeaux University Hospital, Bordeaux, France"},{"name":"Le Hillot Cardiac Rehabilitation Center, Pessac, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Harambat","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Department, Bordeaux University Hospital, Bordeaux, France"},{"name":"INSERM U897, Epidemiology and Biostatistics, ISPED, University of Bordeaux, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Llanas","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Department, Bordeaux University Hospital, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Morin","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"},{"name":"INSERM U1191, URMS 5203, CNRS, Institut de G\u00e9nomique Fonctionnelle, University of Montpellier, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabila","family":"Djouadi","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1878-0936","authenticated-orcid":false,"given":"Stefan","family":"Matecki","sequence":"additional","affiliation":[{"name":"University of Montpellier, PhyMedExp, INSERM, CNRS UMR, Montpellier, France"},{"name":"Department of Physiology, Pediatric Functional Exploration Laboratory, Montpellier University Hospital, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7960-4776","authenticated-orcid":false,"given":"Sophie","family":"Guillaumont","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"},{"name":"Pediatric Cardiology and Rehabilitation Unit, Institut-Saint-Pierre, Palavas-Les-Flots, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8201-5024","authenticated-orcid":false,"given":"Marie","family":"Vincenti","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"},{"name":"University of Montpellier, PhyMedExp, INSERM, CNRS UMR, Montpellier, France"},{"name":"Pediatric Cardiology and Rehabilitation Unit, Institut-Saint-Pierre, Palavas-Les-Flots, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregoire","family":"De La Villeon","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"},{"name":"Pediatric Cardiology and Rehabilitation Unit, Institut-Saint-Pierre, Palavas-Les-Flots, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7848-5536","authenticated-orcid":false,"given":"Victor","family":"Pommier","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"},{"name":"Department of Pediatric and Congenital Cardiology, La Reunion University Hospital, Saint-Denis de La R\u00e9union, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwenaelle","family":"Roussey","sequence":"additional","affiliation":[{"name":"Specialized Pediatric Department, Nantes University Hospital, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2391-7764","authenticated-orcid":false,"given":"Solene","family":"Prigent","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes University, CHU Nantes, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2548-7858","authenticated-orcid":false,"given":"Alban-Elouen","family":"Baruteau","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes University, CHU Nantes, Nantes, France"},{"name":"INSERM, l\u2019Institut du Thorax, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamouda","family":"Abassi","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1025-7909","authenticated-orcid":false,"given":"Mathieu","family":"Andrianoely","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modelling Institute, INSERM U1045, University of Bordeaux, Bordeaux, France"},{"name":"Just Coaching, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4486-2748","authenticated-orcid":false,"given":"Julie","family":"Tenenbaum","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6485-7634","authenticated-orcid":false,"given":"Arthur","family":"Gavotto","sequence":"additional","affiliation":[{"name":"Department of Specialized Pediatrics, Unit of Pediatric Cardiology and Nephrology, Montpellier University Hospital, France"},{"name":"University of Montpellier, PhyMedExp, INSERM, CNRS UMR, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arielle","family":"Desir","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Heart and Lung Center, Heart Research Institute, Children's National Hospital, Georges Washington University School of Medicine and Health Sciences, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary-Kate","family":"Batterton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Heart and Lung Center, Heart Research Institute, Children's National Hospital, Georges Washington University School of Medicine and Health Sciences, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4204-7299","authenticated-orcid":false,"given":"Marie-Christine","family":"Picot","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Department, University Hospital, University of Montpellier, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3649-0294","authenticated-orcid":false,"given":"Pascal","family":"Amedro","sequence":"additional","affiliation":[{"name":"IHU Liryc, Electrophysiology and Heart Modelling Institute, INSERM U1045, University of Bordeaux, Bordeaux, France"},{"name":"Department of Pediatric and Adult Congenital Cardiology, M3C National Reference Center, Bordeaux University Hospital, Bordeaux, France"},{"name":"Department of Pediatrics, Heart and Lung Center, Heart Research Institute, Children's National Hospital, Georges Washington University School of Medicine and Health Sciences, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The QUALIREHAB Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"6","key":"B1-20261009","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.semnephrol.2018.08.002","article-title":"Cardiovascular disease in children and adolescents with chronic kidney disease","volume":"38","author":"Weaver","year":"2018","journal-title":"Semin Nephrol."},{"issue":"7","key":"B2-20261009","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1007\/s00467-016-3325-5","article-title":"Clinical characteristics and prevalence of complications of chronic kidney disease in children: the Taiwan Pediatric Renal Collaborative study","volume":"31","author":"Chou","year":"2016","journal-title":"Pediatr Nephrol."},{"issue":"6","key":"B3-20261009","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1007\/s00467-021-05145-1","article-title":"Epidemiology of pediatric chronic kidney disease\/kidney failure: learning from registries and cohort studies","volume":"37","author":"Harada","year":"2022","journal-title":"Pediatr Nephrol."},{"issue":"1","key":"B4-20261009","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s00467-006-0359-0","article-title":"Cardiovascular complications of pediatric chronic kidney disease","volume":"23","author":"Mitsnefes","year":"2008","journal-title":"Pediatr Nephrol."},{"issue":"5","key":"B5-20261009","doi-asserted-by":"crossref","first-page":"e2022057956","DOI":"10.1542\/peds.2022-057956","article-title":"Atherosclerotic cardiovascular risk as an emerging priority in pediatrics","volume":"150","author":"Schipper","year":"2022","journal-title":"Pediatrics."},{"issue":"9","key":"B6-20261009","doi-asserted-by":"crossref","first-page":"3163","DOI":"10.1007\/s00467-022-05825-6","article-title":"Diagnosis and management of mineral and bone disorders in infants with CKD: clinical practice points from the ESPN CKD-MBD and dialysis working groups and the pediatric renal nutrition taskforce","volume":"38","author":"Bacchetta","year":"2023","journal-title":"Pediatr Nephrol."},{"issue":"11","key":"B7-20261009","doi-asserted-by":"crossref","first-page":"6047","DOI":"10.3390\/ijms23116047","article-title":"Muscle wasting in chronic kidney disease: mechanism and clinical implications-a narrative review","volume":"23","author":"Cheng","year":"2022","journal-title":"Int J Mol Sci."},{"issue":"1","key":"B8-20261009","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s11255-022-03291-5","article-title":"Could sarcopenia-related mortality in end-stage renal disease be underpinned by the number of hospitalizations and cardiovascular diseases?","volume":"55","author":"de Luca Corr\u00eaa","year":"2023","journal-title":"Int Urol Nephrol."},{"issue":"12","key":"B9-20261009","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1136\/heartjnl-2017-312339","article-title":"Cardiopulmonary fitness in children with congenital heart diseases versus healthy children","volume":"104","author":"Amedro","year":"2018","journal-title":"Heart."},{"key":"B10-20261009","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.ijcard.2019.02.069","article-title":"Impaired pulmonary function and its association with clinical outcomes, exercise capacity and quality of life in children with congenital heart disease","volume":"285","author":"Abassi","year":"2019","journal-title":"Int J Cardiol."},{"issue":"4","key":"B11-20261009","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1038\/s41390-024-03143-1","article-title":"Aerobic physical capacity and health-related quality of life in children with sickle cell disease","volume":"96","author":"Laurent-Lacroix","year":"2024","journal-title":"Pediatr Res."},{"issue":"2","key":"B12-20261009","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/s41390-023-02477-6","article-title":"Impaired aerobic capacity in adolescents and young adults after treatment for cancer or non-malignant haematological disease","volume":"94","author":"Gavotto","year":"2023","journal-title":"Pediatr Res."},{"issue":"3","key":"B13-20261009","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1136\/archdischild-2021-323733","article-title":"Cardiopulmonary fitness in children with asthma versus healthy children","volume":"108","author":"Moreau","year":"2023","journal-title":"Arch Dis Child."},{"key":"B14-20261009","doi-asserted-by":"crossref","first-page":"1081106","DOI":"10.3389\/fcvm.2022.1081106","article-title":"Cardiorespiratory fitness, muscle fitness, and physical activity in children with long QT syndrome: a prospective controlled study","volume":"9","author":"Souilla","year":"2022","journal-title":"Front Cardiovasc Med."},{"issue":"2","key":"B15-20261009","doi-asserted-by":"crossref","first-page":"e2461795","DOI":"10.1001\/jamanetworkopen.2024.61795","article-title":"Cardiopulmonary fitness and physical activity among children and adolescents with inherited cardiac disease","volume":"8","author":"Souilla","year":"2025","journal-title":"JAMA Netw Open."},{"issue":"6","key":"B16-20261009","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/j.mayocp.2022.02.029","article-title":"Objectively assessed cardiorespiratory fitness and all-cause mortality risk: an updated meta-analysis of 37 cohort studies involving 2,258,029 participants","volume":"97","author":"Laukkanen","year":"2022","journal-title":"Mayo Clin Proc."},{"key":"B17-20261009","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1016\/j.ijcard.2015.11.028","article-title":"Correlation between cardio-pulmonary exercise test variables and health-related quality of life among children with congenital heart diseases","volume":"203","author":"Amedro","year":"2016","journal-title":"Int J Cardiol."},{"issue":"9889","key":"B18-20261009","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/S0140-6736(13)60595-4","article-title":"Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention","volume":"382","author":"Gansevoort","year":"2013","journal-title":"Lancet."},{"issue":"8","key":"B19-20261009","doi-asserted-by":"crossref","first-page":"273","DOI":"10.31083\/j.rcm2308273","article-title":"Physical activity and exercise for cardiorespiratory health and fitness in chronic kidney disease","volume":"23","author":"Gollie","year":"2022","journal-title":"Rev Cardiovasc Med."},{"issue":"10","key":"B20-20261009","doi-asserted-by":"crossref","first-page":"365","DOI":"10.31083\/j.rcm2510365","article-title":"Cardiovascular disease in chronic kidney disease: implications of cardiorespiratory fitness, race, and sex","volume":"25","author":"Gollie","year":"2024","journal-title":"Rev Cardiovasc Med."},{"issue":"4","key":"B21-20261009","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.jsams.2014.07.005","article-title":"Cardiorespiratory fitness and cardiovascular burden in chronic kidney disease","volume":"18","author":"Howden","year":"2015","journal-title":"J Sci Med Sport."},{"issue":"3","key":"B22-20261009","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1681\/ASN.2007070773","article-title":"Decreased maximal aerobic capacity in pediatric chronic kidney disease","volume":"19","author":"Weaver","year":"2008","journal-title":"J Am Soc Nephrol."},{"key":"B23-20261009","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s13052-016-0255-6","article-title":"Cardiorespiratory fitness and sports activities in children and adolescents with solitary functioning kidney","volume":"42","author":"Tancredi","year":"2016","journal-title":"Ital J Pediatr."},{"issue":"1","key":"B24-20261009","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s13052-016-0299-7","article-title":"Cardiorespiratory fitness: a comparison between children with renal transplantation and children with congenital solitary functioning kidney","volume":"42","author":"Lubrano","year":"2016","journal-title":"Ital J Pediatr."},{"issue":"8","key":"B25-20261009","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1161\/CIR.0b013e3182285a81","article-title":"Value of primordial and primary prevention for cardiovascular disease","volume":"124","author":"Weintraub","year":"2011","journal-title":"Circulation."},{"issue":"16","key":"B26-20261009","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1093\/eurheartj\/ehae085","article-title":"Early hybrid cardiac rehabilitation in congenital heart disease: the QUALIREHAB trial","volume":"45","author":"Amedro","year":"2024","journal-title":"Eur Heart J."},{"issue":"17","key":"B27-20261009","doi-asserted-by":"crossref","first-page":"1865","DOI":"10.1093\/eurjpc\/zwad201","article-title":"Use of new paediatric VO2max reference equations to evaluate aerobic fitness in overweight or obese children with congenital heart disease","volume":"30","author":"Amedro","year":"2023","journal-title":"Eur J Prev Cardiol."},{"issue":"1","key":"B28-20261009","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s40798-023-00622-3","article-title":"Reference values of cardiopulmonary exercise test parameters in the contemporary paediatric population","volume":"9","author":"Amedro","year":"2023","journal-title":"Sports Med Open."},{"issue":"3","key":"B29-20261009","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1681\/ASN.2008030287","article-title":"New equations to estimate GFR in children with CKD","volume":"20","author":"Schwartz","year":"2009","journal-title":"J Am Soc Nephrol."},{"issue":"6","key":"B30-20261009","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1111\/j.1523-1755.2005.00365.x","article-title":"Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO)","volume":"67","author":"Levey","year":"2005","journal-title":"Kidney Int."},{"issue":"10075","key":"B31-20261009","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/S0140-6736(16)32064-5","article-title":"Chronic kidney disease","volume":"389","author":"Webster","year":"2017","journal-title":"Lancet."},{"issue":"10","key":"B32-20261009","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1164\/ajrccm.167.10.950","article-title":"ATS\/ACCP statement on cardiopulmonary exercise testing","volume":"167","author":"Ross","year":"2003","journal-title":"Am J Respir Crit Care Med."},{"issue":"3","key":"B33-20261009","doi-asserted-by":"crossref","first-page":"2000289","DOI":"10.1183\/13993003.00289-2020","article-title":"Official ERS technical standard: global lung function initiative reference values for static lung volumes in individuals of European ancestry","volume":"57","author":"Hall","year":"2021","journal-title":"Eur Respir J."},{"issue":"6","key":"B34-20261009","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1164\/rccm.202205-0963OC","article-title":"A race-neutral approach to the interpretation of lung function measurements","volume":"207","author":"Bowerman","year":"2023","journal-title":"Am J Respir Crit Care Med."},{"issue":"2","key":"B35-20261009","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1378\/chest.101.2.485","article-title":"Oxygen uptake plateau during maximal treadmill exercise in children","volume":"101","author":"Rowland","year":"1992","journal-title":"Chest."},{"issue":"6","key":"B36-20261009","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1136\/bjsm.2009.063180","article-title":"Establishing maximal oxygen uptake in young people during a ramp cycle test to exhaustion","volume":"45","author":"Barker","year":"2011","journal-title":"Br J Sports Med."},{"issue":"3","key":"B37-20261009","first-page":"628","article-title":"Aerobic parameters of exercise as a function of body size during growth in children","volume":"56","author":"Cooper","year":"1984","journal-title":"J Appl Physiol Respir Environ Exerc Physiol."},{"issue":"6","key":"B38-20261009","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1152\/jappl.1986.60.6.2020","article-title":"A new method for detecting anaerobic threshold by gas exchange","volume":"60","author":"Beaver","year":"1986","journal-title":"J Appl Physiol (1985)."},{"issue":"9","key":"B39-20261009","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1093\/eurjpc\/zwad054","article-title":"Reference values of aerobic fitness in the contemporary paediatric population","volume":"30","author":"Gavotto","year":"2023","journal-title":"Eur J Prev Cardiol."},{"issue":"8","key":"B40-20261009","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.recesp.2026.02.003","article-title":"Validation of a VO2max Z-score model for fitness assessment in a healthy Spanish pediatric population","volume":"79","author":"Peir\u00f3-Molina","year":"2026","journal-title":"Rev Esp Cardiol"},{"issue":"2","key":"B41-20261009","doi-asserted-by":"crossref","first-page":"71","DOI":"10.5603\/KP.2019.0018","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension","volume":"77","author":"Williams","year":"2019","journal-title":"Kardiol Pol."},{"issue":"12","key":"B42-20261009","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1093\/ehjci\/jex244","article-title":"Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging","volume":"18","author":"Galderisi","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging."},{"key":"B43-20261009","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jpeds.2015.10.085","article-title":"Left ventricular mass indexing in infants, children, and adolescents: a simplified approach for the identification of left ventricular hypertrophy in clinical practice","volume":"170","author":"Chinali","year":"2016","journal-title":"J Pediatr."},{"issue":"1","key":"B44-20261009","doi-asserted-by":"crossref","first-page":"2458197","DOI":"10.1080\/07853890.2025.2458197","article-title":"Cardiopulmonary fitness in children\/adolescents with chronic kidney disease and the impact of exercise training: a systematic review and meta-analysis of observational study and randomized controlled trials","volume":"57","author":"Zhang","year":"2025","journal-title":"Ann Med."},{"key":"B45-20261009","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1471-2369-15-6","article-title":"Factors associated with chronic musculoskeletal pain in patients with chronic kidney disease","volume":"15","author":"Hsu","year":"2014","journal-title":"BMC Nephrol."},{"issue":"3","key":"B46-20261009","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1002\/jcsm.13471","article-title":"Association of endothelial dysfunction and peripheral arterial disease with sarcopenia in chronic kidney disease","volume":"15","author":"Hsu","year":"2024","journal-title":"J Cachexia Sarcopenia Muscle."},{"issue":"2","key":"B47-20261009","doi-asserted-by":"crossref","first-page":"e1004775","DOI":"10.1371\/journal.pmed.1004775","article-title":"Associations of creatinine muscle index with markers of sarcopenia and mortality in chronic kidney disease: a prospective cohort study","volume":"23","author":"McDonnell","year":"2026","journal-title":"PLoS Med."},{"issue":"1","key":"B48-20261009","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.acvd.2018.07.001","article-title":"French society of cardiology guidelines on exercise tests (part 2): indications for exercise tests in cardiac diseases","volume":"112","author":"Marcadet","year":"2019","journal-title":"Arch Cardiovasc Dis."},{"issue":"1","key":"B49-20261009","doi-asserted-by":"crossref","first-page":"e011214","DOI":"10.1161\/CIRCHEARTFAILURE.123.011214","article-title":"Direct VO2 measurement: getting the fick right for heart transplant eligibility","volume":"17","author":"Schurr","year":"2024","journal-title":"Circ Heart Fail."},{"key":"B50-20261009","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ijcard.2015.03.159","article-title":"Is anemia a new cardiovascular risk factor?","volume":"186","author":"Kaiafa","year":"2015","journal-title":"Int J Cardiol."},{"key":"B51-20261009","doi-asserted-by":"crossref","first-page":"904299","DOI":"10.3389\/fmed.2022.904299","article-title":"Association of exercise with vascular function in patients with CKD: a meta-analysis of randomized controlled trials","volume":"9","author":"Wang","year":"2022","journal-title":"Front Med."},{"issue":"4","key":"B52-20261009","doi-asserted-by":"crossref","first-page":"e0195585","DOI":"10.1371\/journal.pone.0195585","article-title":"Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease","volume":"13","author":"Mukai","year":"2018","journal-title":"PloS One."},{"issue":"2","key":"B53-20261009","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.transproceed.2005.01.051","article-title":"The effect of renal transplantation on pulmonary function and respiratory muscle strength in patients with end-stage renal disease","volume":"37","author":"Guleria","year":"2005","journal-title":"Transplant Proc."},{"issue":"1","key":"B54-20261009","doi-asserted-by":"crossref","first-page":"e1879","DOI":"10.1002\/pri.1879","article-title":"Effectiveness of inspiratory muscle training on respiratory fitness and breathlessness in chronic renal failure: a randomized control trial","volume":"26","author":"Yuenyongchaiwat","year":"2021","journal-title":"Physiother Res Int."},{"issue":"1","key":"B55-20261009","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1681\/ASN.2013040348","article-title":"Functional cardiovascular reserve predicts survival pre-kidney and post-kidney transplantation","volume":"25","author":"Ting","year":"2014","journal-title":"J Am Soc Nephrol."},{"issue":"suppl 1","key":"B56-20261009","first-page":"S46","article-title":"Exercise rehabilitation and skeletal muscle benefits in hemodialysis patients","volume":"61","author":"Deligiannis","year":"2004","journal-title":"Clin Nephrol"},{"issue":"2","key":"B57-20261009","doi-asserted-by":"crossref","first-page":"552","DOI":"10.3390\/jcm13020552","article-title":"Renal rehabilitation: present and future perspectives","volume":"13","author":"Kohzuki","year":"2024","journal-title":"J Clin Med."},{"issue":"4","key":"B58-20261009","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s11255-021-02949-w","article-title":"Effects of exercise on markers of inflammation and indicators of nutrition in patients with chronic kidney disease: a systematic review and meta-analysis","volume":"54","author":"Wu","year":"2022","journal-title":"Int Urol Nephrol."},{"issue":"3","key":"B59-20261009","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/wvn.12634","article-title":"The effectiveness of patient activation interventions in adults with chronic kidney disease: a systematic review and meta-analysis","volume":"20","author":"Lunardi","year":"2023","journal-title":"Worldviews Evid Based Nurs."},{"issue":"1","key":"B60-20261009","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1053\/j.ajkd.2022.06.008","article-title":"Effect of long-term exercise training on physical performance and cardiorespiratory function in adults with CKD: a randomized controlled trial","volume":"81","author":"Weiner","year":"2023","journal-title":"Am J Kidney Dis."},{"issue":"5","key":"B61-20261009","doi-asserted-by":"crossref","first-page":"F638","DOI":"10.1152\/ajprenal.00152.2023","article-title":"The effect of exercise on vascular health in chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials","volume":"325","author":"Davies","year":"2023","journal-title":"Am J Physiol Renal Physiol."}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:01:11Z","timestamp":1791558071000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":61,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.0000001113","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"assertion":[{"value":"2026-03-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}