Impaired muscle oxygen metabolism in uremic children: improved after renal transplantation.
(Clinical Trial;Journal Article)
BACKGROUND: The purpose of this study is to clarify skeletal muscle oxidative metabolism in children with end-stage renal disease (ESRD) before and after renal transplantation. METHODS: We examined muscle oxygenation and metabolism by using noninvasive near-infrared spectroscopy in 10 patients (age, 12.4 +/- 3.1 years) 1 week before and 4 weeks after renal transplantation and in 10 controls (age, 12.8 +/- 2.6 years) during submaximal hand-grip exercise using the flexor digitorum superficialis muscle. We used 2 indicators to evaluate muscle metabolism. The rate of initial decrease in hemoglobin/myoglobin deoxygenation during arterial occlusion after exercise relative to the value at rest (S2/S1) was used as an indicator of mitochondrial oxygen consumption, whereas recovery time (TR) after exercise was used as an indicator of oxygen delivery to the muscle and aerobic capacity. RESULTS: S2/S1 and TR after exercise were significantly lower in patients before renal transplantation compared with the control group (P < 0.05). S2/S1 and TR after exercise improved significantly after renal transplantation (P < 0.01, P < 0.05) and were not significantly different from those of controls. CONCLUSION: Oxidative metabolism in skeletal muscle during exercise is impaired in children with ESRD and recovers after renal transplantation.
Matsumoto, N; Ichimura, S; Hamaoka, T; Osada, T; Hattori, M; Miyakawa, S
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