RecruitingPhase 2NCT02947750

Neurovascular Transduction During Exercise in Chronic Kidney Disease

Neurovascular Regulation During Exercise in Humans With Chronic Kidney Disease


Sponsor

Emory University

Enrollment

150 participants

Start Date

Oct 1, 2016

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of this study is to find out why patients with chronic kidney disease (CKD) have poor exercise capacity and to explore what causes an increase in blood pressure during exercise (i.e. increased adrenaline levels, or decreased ability of blood vessels to dilate). This study will also test whether or not regular exercise on a bicycle and/or treatment with 6R-BH4 (Kuvan) pills, or histidine and beta-alanine supplementation improves these measures during exercise. 6R-BH4 is currently FDA-approved for use in patients with certain forms of a disease called phenylketonuria, but it is not currently FDA approved for blood pressure or exercise capacity in people with CKD.


Eligibility

Min Age: 18 YearsMax Age: 75 Years

Plain Language Summary

Simplified for easier understanding

This study examines how the nervous system controls blood flow to the muscles during exercise in people with chronic kidney disease (CKD), to understand why CKD patients often have reduced exercise capacity and fatigue more easily. **You may be eligible if...** - You have been diagnosed with stage 3 or 4 chronic kidney disease (your kidneys are working at roughly 15–59% of normal capacity) - Your kidney function has been stable (not rapidly declining) over the past 3 months - You do not currently exercise regularly (less than 30 minutes, 3 times per week) **You may NOT be eligible if...** - You have unstable or rapidly worsening kidney function - You already exercise regularly - You have severe heart disease or other conditions that make exercise unsafe - You are pregnant Understanding why CKD reduces exercise tolerance could lead to better exercise programs and therapies that improve kidney patients' quality of life. Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

DRUG6R-BH4

Participants will receive 200 mg of 6R-BH4 twice daily for 12 weeks. Study pills are dissolved in water or apple juice, and taken with food.

OTHER6R-BH4 placebo

Participants will receive a placebo that is identical to 200 mg of 6R-BH4. The placebo will be taken twice daily for 12 weeks. Study pills are dissolved in water or apple juice, and taken with food.

DIETARY_SUPPLEMENTFolic acid

Participants will take 1 mg of folic acid daily for 12 weeks. Folic acid is given because it enhances the binding affinity of BH4 to nitric oxide synthase (NOS), and also enhances the regeneration of BH4 from inactive BH2

OTHERExercise training

Participants will exercise 3 times a week on a stationary ergometer. Exercise intensity will begin at low levels (50% of maximal heart rate reserve) calculated utilizing the Karvonen method. Briefly, target exercise heart rate (HR) is calculated by subtracting the persons age from 220. Resting heart rate is then subtracted from this number. The answer is then multiplied by the target percent (50% for example) and the product is added back to resting heart rate to provide the target exercise session heart rate. Intensity will be increased by 5% every week (as tolerated by the participant) to a maximum of 80% of maximal heart rate. Exercise time will progress from an initial 20 minutes per session to a maximum of 45 minutes by increasing 5 minutes each week.

OTHERStretching

Participants randomized to 'No Exercise Training' group will instead of aerobic exercise, undergo progressive whole body stretching and toning exercises designed for individuals 65 and older. This type of low intensity activity is designed not to increase heart rate and will serve as the Control group to the Exercise Training group. The Control group will come in for stretching sessions 3 times per week for 20-45 minutes.

DIETARY_SUPPLEMENTHistidine and beta-alanine supplementation

Histidine and beta-alanine are two over-the-counter supplements commonly used to enhance sports performance in athletes. Participants randomized to this study arm will receive combined histidine (4g/day) and beta-alanine (3.2g/day) supplementation.

OTHERHistidine and beta-alanine placebo

Participants randomized to this study arm will receive a placebo to match combined histidine (4g/day) and beta-alanine (3.2g/day) supplementation.


Locations(3)

Emory University Hospital Midtown

Atlanta, Georgia, United States

Emory University Hospital

Atlanta, Georgia, United States

Atlanta VA Health Care System

Decatur, Georgia, United States

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NCT02947750


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