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International Urology and Nephrology

, Volume 46, Issue 8, pp 1655–1662 | Cite as

Resistance exercise: a strategy to attenuate inflammation and protein-energy wasting in hemodialysis patients?

  • Cristiane Moraes
  • Sandra Mara Marinho
  • Antonio Claudio da Nobrega
  • Bruno de Oliveira Bessa
  • Ludmilla Viana Jacobson
  • Milena Barcza Stockler-Pinto
  • Wellington Seguins da Silva
  • Denise Mafra
Nephrology - Original Paper

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords

Chronic kidney disease Hemodialysis Inflammation Exercise Cardiovascular disease 

Abbreviations

AMA

Arm muscle area

FFM

Fat-free mass

RETP

Resistance exercise training program

STS

Sit-to-stand

Notes

Acknowledgments

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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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Cristiane Moraes
    • 1
    • 5
  • Sandra Mara Marinho
    • 2
  • Antonio Claudio da Nobrega
    • 1
  • Bruno de Oliveira Bessa
    • 2
  • Ludmilla Viana Jacobson
    • 3
  • Milena Barcza Stockler-Pinto
    • 1
  • Wellington Seguins da Silva
    • 4
  • Denise Mafra
    • 1
    • 2
  1. 1.Graduate Program in Cardiovascular SciencesFluminense Federal University (UFF)NiteróiBrazil
  2. 2.Graduate Program in Medical SciencesFluminense Federal University (UFF)NiteróiBrazil
  3. 3.Departmant of StatisticsFluminense Federal University (UFF)NiteróiBrazil
  4. 4.Immunology InstituteOswaldo Cruz Foundation (FIOCRUZ)Rio de JaneiroBrazil
  5. 5.Botafogo, Rio de JaneiroBrazil

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