{"id":"c9a5eb63f07f","type":"article","url":"https://hartvaat.nl/2026/10/09/diabetes-verslechtert-cardiorespiratoire-fitheid-en-autonome-functie-bij-nierpat/","title":"Diabetes verslechtert cardiorespiratoire fitheid en autonome functie bij nierpatiënten","title_en":"The presence of diabetes in chronic kidney disease is associated with lower cardiorespiratory fitness.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"The Journal of sports medicine and physical fitness","doi":"10.23736/S0022-4707.26.17225-9","source_url":"https://doi.org/10.23736/S0022-4707.26.17225-9","authors":["Rachel E Colbran","Liam P Voysey","Erin J Howden","Anthony S Leicht","Nicole Isbel","Jeff S Coombes","Kassia S Beetham"],"significance":3,"published":"2026-10-17","source_date":"2026-10-09","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/"],"congress":"","summary_en":"This observational study of 72 patients with stage 3-4 chronic kidney disease found that diabetes is associated with significantly lower peak oxygen uptake (VO2peak) and impaired autonomic function (HRV) compared to non-diabetic CKD patients. While age, BMI, and diabetes status predicted fitness levels, no correlation was found between VO2peak and HRV. Clinically, this highlights the need for targeted fitness and cardiovascular risk management in diabetic CKD patients, without supporting the use of HRV as a direct surrogate marker for cardiorespiratory capacity.","created":"2026-10-10T01:37:52Z","updated":"2026-10-10T01:37:52Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een observatiestudie onder 72 patiënten met chronische nierziekte (stadia 3-4) toont aan dat diabetes gepaard gaat met een lagere piepopname van zuurstof (VO2peak) en verminderde autonome zenuwfunctie (HRV) vergeleken met nierpatiënten zonder diabetes. Multivariate analyse bevestigt dat leeftijd, BMI en diabetesstatus de fitheid voorspellen, maar er is geen verband tussen VO2peak en HRV. Voor de klinische praktijk onderstreept dit dat nierpatiënten met diabetes extra aandacht vragen voor fitheidsbevordering en cardiovasculair risicomanagement, zonder dat HRV-metingen direct als biobehandelmarker kunnen worden ingezet.","abstract_original":"BACKGROUND: Patients with chronic kidney disease (CKD) have reduced cardiorespiratory fitness, which is associated with a higher incidence of cardiovascular disease and mortality. The aim of this study was to investigate the relationship between cardiorespiratory fitness and autonomic nervous system function in patients with chronic kidney disease, with and without diabetes mellitus. METHODS: Seventy-two patients with stage 3-4 chronic kidney disease (27 without diabetes mellitus and 45 with diabetes mellitus), and 22 age-matched controls were included. Autonomic function was assessed through measurement of time, frequency and non-linear components of heart rate variability (HRV) during a 5-min supine electrocardiography recording. Cardiorespiratory fitness (measured by peak oxygen uptake [VO<inf>2peak</inf>]) was assessed by a cardiopulmonary exercise test. RESULTS: Several HRV parameters (6 out of 11 variables) were significantly lower (P<0.05) in patients with chronic kidney disease compared to healthy controls. Further, the majority of HRV parameters, and VO<inf>2peak</inf>, were significantly lower (P<0.05) in the patients with diabetes compared to those without diabetes. A multiple linear regression identified age, body mass index (BMI) and diabetes status as significant predictors of VO<inf>2peak</inf> in patients with CKD (adjusted R2=0.51, P<0.001), however there was no association between VO<inf>2peak</inf> and HRV (standard deviation of the N-N interval). This lack of association remained when an SDNN and diabetes interaction was included in the model. CONCLUSIONS: CKD patients with diabetes have worsened heart rate variability and cardiorespiratory fitness compared to those without diabetes. However, there is no association between heart rate variability and cardiorespiratory fitness, regardless of diabetes status. Future research should investigate other pathological systems which may be contributing to reduced cardiorespiratory fitness in the CKD population."}