The immune response in hemodialysis patients following physical training

Abstract

The effects of mild physical training on the cell-mediated and humoral immune responses were studied in 18 patients with end-stage renal disease (6.5±5.2 years on hemodialysis) participating in a six month exercise renal rehabilitation program. They were matched with 14 untrained patients for sex, age, years on hemodialysis and causes of renal disease. Serum immunoglobulins (IgA, IgM, IgG), IgG subclasses (IgG₁, IgG₂, IgG₃, IgG₄), complement components (C₃, C₄), interleukins IL-2, IL-4, IL-6, subpopulations of T lymphocytes and panel reactive lymphocytotoxic antibodies were determined on all patients. By the end of the study, peak aerobic capacity (VO₂ peak) was significantly improved by 42% in the trained group. This improvement was followed by a non-significant increase in IgE (by 13.8%) and in IgM (by 3%) and a decrease in IgA (by 17.5%, p<0.05), while the IgG levels remained constant. In the control group, there was no change in the levels of immunoglobulins. The values of interleukins, IgG subclasses, complement, lymphocytotoxic antibodies and T lymphocyte subsets remained almost unchanged in both groups. Finally, during the study, common upper respiratory infections were more often in the controls (58%), than in the trained patients (31%). The results suggest that physical training improves clinically the immune defense mechanisms in hemodialysis patients, although it does not significantly change cell-mediated and humoral immune responses.