Effect of resistance training on pathological cardiac hypertrophy and FGF23-Klotho axis-induced adverse cardiovascular outcomes in rats with CKD

Patients with chronic kidney disease (CKD) confront with cardiovascular disease (CVD) complications which can be ameliorated with exercise. The purpose of the current study was to determine the effect of resistance training on pathological cardiac hypertrophy and FGF23-Klotho axis-induced adverse cardiovascular outcomes in rat model of CKD. Thirty male Wistar rats (7–8 weeks old) were randomly divided into three groups of the 5/6 nephrectomy (5/6NX) with and without resistance training and control group. The resistance training protocol consisted of 3 sessions per week. The proposed blood factors (Klotho, FGF23, serum phosphorus, parathyroid hormone, serum calcium, and vitamin D) evaluated for three groups at the end of 8th week. After confirming the normal distribution of data through Kolmogorov–Smirnov test, data analysis was performed by one-way ANOVA and Bonferroni post hoc test ( P > 0.05). The effect of resistance training was significantly different between 3 groups of study for hypertrophy ( P = 0.036) and cardiac function ( P = 0.004). There was also a significant difference for blood factors of Klotho ( P = 0.000), FGF23 ( P = 0.043), serum phosphorus ( P = 0.00), and parathyroid ( P = 0.00). Serum calcium ( P = 0.06) and vitamin D status ( P = 0.06) improved but the differences were not significant. Resistance training can prevent progression of pathological cardiac hypertrophy in patients with renal disease. In the process of this improvement, changes in FGF23 and Klotho were significant; however, the vitamin D and calcium have played a less important role. Graphical Abstract