Resistance exercise: a strategy to attenuate inflammation and protein-energy wasting in hemodialysis patients?
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Patients undergoing hemodialysis (HD) present persistent inflammation and protein-energy wasting (PEW), which contributes to high rates of mortality. This study aimed to assess the effects of a resistance exercise training program (RETP) on inflammation and PEW in HD patients.
Thirty-seven patients (56.7 % men, 45.9 ± 14.1 years, 23.5 ± 3.9 kg/m2) performed 6 months of intradialytic RETP. Plasma adhesion molecules levels (ICAM-1 and VCAM-1) were measured using the enzyme immunometric assay, and interleukin-6 (IL-6), C-reactive protein, and tumor necrosis factor-alpha by ELISA. Anthropometric, physical capacity, and PEW (simultaneously presence of: BMI <23 kg/m2, serum albumin <3.8 g/dL, and reduced arm muscle area) were analyzed.
There was a reduction of ICAM-1 [(1,934.1 pg/mL (1,031.8–2,875.0) vs. 1,571.1 pg/mL (447.1–2,985.5), p < 0.05], VCAM-1 [5,259.51 pg/mL (3,967.4–6,682.4) vs. 3,062.11 pg/mL (2,034.0–5,034.4), p < 0.05], and CRP levels (2.3 ± 0.9 to 1.6 ± 0.6 pg/mL, p < 0.001) after 6 months of RETP. Body composition improved, albumin increased (3.7 ± 0.3 to 3.9 ± 0.2, p < 0.05), and the number of patients presenting PEW was decreased (p = 0.005).
Resistance exercise program for 6 months seems to be effective in reducing inflammation and PEW of HD patients. The universal trial number of this study is U1111-1139-1326.
KeywordsChronic kidney disease Hemodialysis Inflammation Exercise Cardiovascular disease
Arm muscle area
Resistance exercise training program
The author acknowledges the Support Foundation for Research of the State of Rio de Janeiro (FAPERJ) and Coordination of Improvement of Superior Education Personnel (CAPES). We also acknowledge Gama Filho University where the patients performed tests of strength and physical capacity.
Conflict of interest
The authors declare that there are no conflicts of interest and that the results presented in this paper have not been published previously in whole or part, except in abstract format.
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