Effects of acute exercise on markers of inflammation in pediatric chronic kidney disease: a pilot study

Children and adolescents with chronic kidney disease (CKD) are chronically exposed to high levels of inflammation, placing them at an increased risk of secondary health complications. Regular exercise may represent an effective therapy to reduce inflammation. The aims of this pilot study were to determine the effects of acute exercise on inflammation and immune cell counts in CKD. Nine children and adolescents (4 males) with CKD stages III-V performed a graded exercise test to determine peak oxygen uptake (VO2peak). Following a 10-min break, participants cycled for 20 min at 50 % of VO2peak. Blood samples were collected before and after the exercise period for the determination of complete blood counts, natural killer cells (NKbright, NKdim) and circulating progenitor cell (CPC) counts, as well as interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) concentrations. Complete blood counts and NKdim cell and CPC counts were unchanged with exercise. Following exercise, NKbright cell counts increased (7.4 +/- 4.3 vs. 12.2 +/- 8.3 x 10(6) cells/L; p = 0.02), while trends were observed for an increase in IL-6 (2.1 +/- 2.2 vs. 2.7 +/- 2.6 pg/mL; p = 0.08), decrease in TNF-alpha (4.5 +/- 1.2 vs. 4.2 +/- 1.0 pg/mL; p = 0.08) and an increase in the IL-6:TNF-alpha ratio (0.6 +/- 0.7 vs. 0.8 +/- 0.8; p = 0.07). Our findings suggest that acute exercise may create an anti-inflammatory environment in children and adolescents with CKD stages III-V.