Study design
Stage IIIB, CKD
This randomized, controlled clinical trial was registered at clinicaltrials.gov (NCT02947750). Participants were allocated to an Exercise training group or a control Stretching group using a computer-generated sequence stratified by stage of CKD (Stage IIIA, Stage IIIB, and Stage IV). After obtaining written informed consent, baseline MSNA, brachial BP, body composition, and basic metabolic panel were obtained. On a separate day, baseline aortic hemodynamics, pulse wave analysis, and PWV were measured. All measurements were obtained in a quiet, temperate (21°C) environment, after abstaining from food, caffeine, smoking, and alcohol for at least 12 hours, and after abstaining from exercise for at least 24 hours. Participants were allowed to drink water. After baseline assessments, participants were randomly assigned to 1 of 2 structured, supervised interventions that took place at a frequency of 3 days per week for the duration of 12 weeks (36 sessions total). The aerobic exercise intervention (“spin”) was administered to test the effects of aerobic exercise training on CV health in CKD. The nonaerobic control intervention (stretching and balance) was administered in parallel as the active control intervention conducted within the same group-based environment. At the end of the trial, baseline measurements were repeated under identical conditions within 1 week following the completion of the final training session. Participants were instructed not to change medication regimens, dietary or smoking habits, or home activity levels for the duration of the study. Data from a subset of participants (