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Am J Physiol Regul Integr Comp Physiol 280: R1240-R1248, 2001;
0363-6119/01 $5.00
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Vol. 280, Issue 4, R1240-R1248, April 2001

Impaired muscle oxygen transfer in patients with chronic renal failure

Ernest Sala1, Elizabeth A. Noyszewski2, Josep M. Campistol1, Ramon M. Marrades1, Steffi Dreha2, Josep V. Torregrossa1, Jennifer S. Beers2, Peter D. Wagner3, and Josep Roca1

1 Servei de Pneumologia i Allèrgia Respiratòria, Unitat de Transplantament Renal, Departament de Medicina, Institut d'Investigacions Biomèdiques Pi i Sunyer, Hospital Clínic, Barcelona 08036, Spain; 2 Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104; and 3 Section of Physiology, Department of Medicine, University of California San Diego, La Jolla, California 92093

We hypothesized that impaired O2 transport plays a role in limiting exercise in patients with chronic renal failure (CRF). Six CRF patients (25 ± 6 yr) and six controls (24 ± 6 yr) were examined twice during incremental single-leg isolated quadriceps exercise. Leg O2 delivery (QO2leg) and leg O2 uptake (VO2leg) were obtained when subjects breathed gas of three inspired O2 fractions (FIO2) (0.13, 0.21, and 1.0). On a different day, myoglobin O2 saturation and muscle bioenergetics were measured by proton and phosphorus magnetic resonance spectroscopy. CRF patients, but not controls, showed O2 supply dependency of peak VO2 (VO2peak) by a proportional relationship between peak VO2leg at each inspired O2 fraction (0.59 ± 0.20, 0.47 ± 0.10, 0.43 ± 0.10 l/min, respectively) and 1) work rate (933 ± 372, 733 ± 163, 667 ± 207 g), 2) QO2leg (0.80 ± 0.20, 0.64 ± 0.10, 0.59 ± 0.10 l/min), and 3) cell PO2 (6.3 ± 5.4, 1.7 ± 1.3, 1.2 ± 0.7 mmHg). CRF patients breathing 100% O2 and controls breathing 21% O2 had similar peak QO2leg (0.80 ± 0.20 vs. 0.79 ± 0.10 l/min) and similar peak VO2leg (0.59 ± 0.20 vs. 0.57 ± 0.10 l/min). However, mean capillary PO2 (47.9 ± 4.0 vs. 38.2 ± 4.6 mmHg) and the capillary-to-myocite gradient (40.7 ± 6.2 vs. 34.4 ± 4.0 mmHg) were both higher in CRF patients than in controls (P < 0.03 each). We conclude that low muscle O2 conductance, but not limited mitochondrial oxidative capacity, plays a role in limiting exercise tolerance in these patients.

chronic renal failure; exercise; oxygen transport; nuclear magnetic resonance spectroscopy; intracellular partial pressure of oxygen


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