Diabetic Kidney Disease: Influence of Exercise on Physical and Vascular Function

描述(申请人提供)：Bronas博士是明尼苏达大学护理学院的临床运动生理学家和临床助理教授。这项建议的目的是将Bronas博士培养成一名独立的临床研究人员，长期目标是在肾脏疾病相关心血管疾病的一级和二级预防中使用治疗性生活方式干预进行临床研究。职业发展计划包括多学科方法，以促进临床研究的转换和跨学科方法。该培训计划旨在为布罗纳斯博士提供严密指导的、以患者为导向的临床研究经验，以及有条理的教学和课程作业。Painter博士和Rosenberg博士将与心脏病专家、肾病学家和临床试验专家一起提供主要指导，组成指导咨询委员会。这项拟议研究的目的是验证这样一个假设，即与常规医疗对照组(n=40)相比，有监督的运动疗法(n=40)将改善透析前2型糖尿病肾病(DKD)男性和女性的血管(内皮)功能、动脉结构(僵硬/顺应性)和血管健康生物标志物。这项研究将进一步检验这一假设，即有监督的运动治疗计划将改善身体功能。这项研究正在调查一种辅助治疗方案(运动疗法)，这是以前没有在DKD患者中研究过的，也不是临床实践的常规部分。这项拟议的研究将首次调查运动疗法对与DKD患者心血管疾病进展相关的血管健康因素的影响，如果成功，将为运动训练作为DKD患者的辅助治疗选择的有效性提供有价值的见解。 相关性：这项研究意义重大，因为它将是第一个调查运动疗法对DKD患者血管健康影响的研究。这项研究将增加我们对运动疗法改善这一人群血管健康的效用的理解，并产生关于运动疗法对DKD患者心血管疾病进展相关因素的影响的新假说，从而为新的辅助治疗方案提供洞察力。

DESCRIPTION (provided by applicant): Dr. Bronas is a Clinical Exercise Physiologist and a Clinical Assistant Professor in the School of Nursing at the University of Minnesota. The purpose of this proposal is to develop Dr. Bronas into an independent clinical researcher with the long-term goal of conducting clinical research using therapeutic lifestyle interventions in the primary and secondary prevention of renal disease related cardiovascular disease. The career development plan consists of a multi-disciplinary approach to foster a translational and inter-disciplinary approach to clinical research. The training program is designed to provide Dr. Bronas with a closely mentored patient-oriented clinical research experience with structured didactics and course work. The primary mentorship will be provided by Drs. Painter and Rosenberg with cardiologists, nephrologists, and clinical trial experts making up the mentoring advisory committee. The objective of the proposed research is to test the hypothesis that a supervised exercise therapy program (n=40) will improve vascular (endothelial) function, arterial structure (stiffness/compliance), and vascular health biomarkers in men and women with pre-dialysis type 2 diabetic kidney disease (DKD), as compared to a usual medical care control group (n=40). This study will further test the hypothesis that a supervised exercise therapy program will improve physical function. This study is investigating an adjunct treatment option (exercise therapy) previously not studied in patients with DKD and which is not a routine part of clinical practice. The proposed study will be the first to investigate the effect of exercise therapy on vascular health factors that are related to the progression of CVD in patients with DKD and if successful, offer a valuable insight into the efficacy of exercise training as an adjunct therapeutic option for patients with DKD. RELEVANCE: This study is significant because it will be the first study to investigate the impact of exercise therapy on vascular health in patients with DKD. This study will increase our understanding of the utility of exercise therapy to improve vascular health in this population, and generate new hypotheses regarding the impact of exercise therapy on factors associated with the progression of CVD in patients with DKD, and thus provide insight into a new and adjunct treatment option.