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Effects of moderate-intensity concurrent exercise training on cardiovascular risk factors in patients with chronic kidney disease undergoing hemodialysis: a randomized control trial

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Abstract

Purpose

Patients with chronic kidney disease (CKD) undergoing hemodialysis are generally physically inactive, have a high mortality rate due to cardiovascular disease (CVD), and may benefit from an exercise program to improve CKD-induced CVD causatives. Our purpose was to examine the effects of concurrent exercise training on CVD risk factors including peak oxygen uptake (\(\dot{V}{\text{O}}_{{2}} {\text{peak}}\)), C-reactive protein (CRP), asymmetric isomer of dimethylarginine (ADMA), fibroblast growth factor-23 (FGF-23), and glycated hemoglobin (HbA1c) in end-stage renal disease patients undergoing hemodialysis.

Methods

We performed a 12-week randomized controlled feasibility study examining the effects of a concurrent aerobic and resistance training on the aforementioned variables. Patients (age = 50.1 ± 14 years) randomized to either exercise training group (ET) (2 day/week of aerobic training with 40–60% \(\dot{V}{\text{O}}_{{2}} {\text{peak}}\) during dialysis; and 2 day/week of resistance training with rating of perceived exertion of 10–15 of 20 during rest), or untrained control group (CON).

Results

The employed exercise increased \(\dot{V}{\text{O}}_{{2}} {\text{peak}}\) (13.8%, p = 0.005) and decreased plasma levels of CRP (− 18.7%, p = 0.01), ADMA (− 9.1%, p = 0.01), FGF-23 (− 10.5%, p = 0.05), and HbA1c (− 7.9%, p = 0.01). Also, the change in \(\dot{V}{\text{O}}_{{2}} {\text{peak}}\) and HbA1c level in ET group was significantly greater than that of CON group (p = 0.04 and 0.05, respectively).

Conclusion

These findings provide compelling evidence that combined aerobic and resistance exercise could be considered as a potent stimulus to induce adaptations in aerobic capacity and decrease CVD risk factors in patients with chronic kidney disease.

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Original source data is available under reasonable request.

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Funding

No external financial support was received for this study.

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Authors and Affiliations

  1. Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Guilan, 4199613776, Rasht, Iran

    Saeid Shokati Basir & Bahman Mirzaei

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  1. Saeid Shokati Basir
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  2. Bahman Mirzaei
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All authors contributed equally to this study.

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Correspondence to Bahman Mirzaei.

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All procedures were in accordance with the ethical principles of the Declaration of Helsinki, approved by the ethical committee of the University of Guilan.

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44 patients gave their written informed consent and volunteered to participate in the experiment.

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Basir, S.S., Mirzaei, B. Effects of moderate-intensity concurrent exercise training on cardiovascular risk factors in patients with chronic kidney disease undergoing hemodialysis: a randomized control trial. Sport Sci Health 18, 1397–1404 (2022). https://doi.org/10.1007/s11332-022-00911-6

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  • DOI: https://doi.org/10.1007/s11332-022-00911-6

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