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Effect of resistance training during hemodialysis on circulating cytokines: a randomized controlled trial

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Abstract

The purpose of this study was to evaluate the effect of a 12-week intradialytic progressive resistance training (PRT) regimen on circulating pro- and anti-inflammatory cytokines. Forty-nine patients (62.6 ± 14.2 years) were recruited from the outpatient hemodialysis unit of the St. George Public Hospital, Sydney, Australia. Patients were randomized to: PRT + usual care (n = 24) or usual care control (n = 25). The PRT group performed two sets of 10 exercises at high intensity using free-weights, 3 times per week for 12 weeks during dialysis, while the control group did not exercise. Tumor necrosis factor-alpha, interleukin-1b, interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10, and interleukin-12 were measured in serum before and after the intervention period. Muscle cross-sectional area (CSA), intramuscular lipid, intermuscular adipose tissue, and subcutaneous and total thigh fat, evaluated via computed tomography of the non-dominant mid-thigh, were also collected at both time points. All cytokines were significantly elevated in the total cohort at baseline compared with normative data. There were no cytokine changes over time or between groups (p > 0.05). In secondary analyses pooling the groups, changes in logIL-6 and IL-8 were inversely related to changes subcutaneous thigh fat (p < 0.05) while changes in logIL-6 were also inversely related to changes in thigh muscle CSA, and total thigh fat (p < 0.03). These data suggest that 12 weeks of intradialytic progressive resistance training does not improve circulating pro- and anti-inflammatory markers. Further research is required to elucidate the implications and mechanisms of the relationships between IL-6 and IL-8 and body composition in ESRD.

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References

  • Albert MA, Glynn RJ, Ridker PM (2004) Effect of physical activity on serum C-reactive protein. Am J Cardiol 93(2):221–225

    Article  PubMed  CAS  Google Scholar 

  • Baune B, Ponath G, Golledge J, Varga G, Arolt V, Rothermundt M et al (2008) Association between IL-8 cytokine and cognitive performance in an elderly general population—the MEMO-study. Neurobiol Aging 29(6):937–944

    Article  PubMed  CAS  Google Scholar 

  • Bergstrom J, Lindholm B (2000) What are the causes and consequences of the chronic inflammatory state in chronic dialysis patients. Semin Dial 13(3):163–164

    Article  PubMed  CAS  Google Scholar 

  • Bologa R, Levine D, Parker T, Cheigh J, Serur D, Stenzel K et al (1998) Interleukin-6 predicts hypoalbuminemia, hypocholesterolemia, and mortality in hemodialysis patients. Am J Kidney Dis 32(1):107–114

    Article  PubMed  CAS  Google Scholar 

  • Bruunsgaard H (2005) Physical activity and modulation of systemic low-level inflammation. J Leukoc Biol 78:819–835

    Article  PubMed  CAS  Google Scholar 

  • Castaneda C, Gordon P, Parker R, Uhlin K, Roubenoff R, Levey A (2004) Resistance training to reduce the malnutrition-inflammation complex syndrome of chronic kidney disease. Am J Kidney Dis 43(4):607–616

    Article  PubMed  Google Scholar 

  • Chauveau P, Level C, Lasseur C, Bonarek H, Peuchant E, Montaudon D et al (2003) C-reactive protein and procalcitonin as markers of mortality in hemodialysis patients: a 2-year prospective study. J Ren Nutr 13(2):137–143

    Article  PubMed  Google Scholar 

  • Cheema B (2008) Tackling the survival issue in end stage renal disease: time to get physical on haemodialysis. Nephrology (Carlton) 3(7):560–569

    Article  Google Scholar 

  • Cheema B, O’Sullivan A, Chan M, Patwardhan A, Kelly J, Gillin A et al (2006) Progressive resistance training during hemodialysis: rationale and method of a randomized controlled trial. Hemodial Int 10:303–310

    Article  PubMed  Google Scholar 

  • Cheema B, Abas H, Smith B, O’Sullivan A, Chan M, Patwardhan A et al (2007a) Progressive exercise for anabolism in kidney disease (PEAK): a randomized controlled trial of resistance training during hemodialysis. J Am Soc Nephrol 18(5):1594–1601

    Article  PubMed  Google Scholar 

  • Cheema B, Abas H, Smith B, O’Sullivan A, Chan M, Patwardhan A et al (2007b) Randomized controlled trial of intradialytic resistance training to target muscle wasting in ESRD: the progressive exercise for anabolism in kidney disease (PEAK) study. Am J Kidney Dis 50(4):574–584

    Article  PubMed  Google Scholar 

  • Church TS, Barlow CE, Earnest CP, Kampert JB, Priest EL, Blair SN (2002) Associations between cardiorespiratory fitness and C-reactive protein in men. Arterioscler Thromb Vasc Biol 22(11):1869–1876

    Article  PubMed  CAS  Google Scholar 

  • Coe R (2006) Effect size calculator: a user guide to using the spreadsheet. http://www.cemcentre.org/renderpage.asp?linkID=30325017. Accessed 9 Nov 2006

  • Colbert L, Visser M, Simonsick E, Tracy R, Newman A, Kritchevsky S, et al (2004) Physical activity, exercise, and inflammatory markers in older adults: findings from the health, aging and body composition study. J Am Geriatr Soc 52(7):1098–1104

    Google Scholar 

  • Conraads V, Beckers P, De Clerck L, Stevens L, Vrints C, Brutsaert D (2002) Combined endurance/resistance training reduces plasma TNF-α receptor levels in patients with chronic heart failure and coronary artery disease. Eur Heart J 23:1854–1860

    Article  PubMed  CAS  Google Scholar 

  • Fiatarone MA, O’Neill EF, Ryan ND, Clements KM, Solares GR, Nelson ME et al (1994) Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 330(25):1769–1775

    Article  PubMed  CAS  Google Scholar 

  • Frederiksen L, Nielsen T, Wraae K, Hagen C, Frystyk J, Flyvbjerg A et al (2009) Subcutaneous rather than visceral adipose tissue is associated with adiponectin levels and insulin resistance in young men. J Clin Endocrinol Metab 94(10):4010–4015

    Article  PubMed  CAS  Google Scholar 

  • Gielen S, Adams V, Mobius-Winkler S, Linke A, Erbs S, Yu J et al (2003) Anti-inflammatory effects of exercise training in skeletal muscle of patients with chronic heart failure. J Am Coll Cardiol 42(5):861–868

    Article  PubMed  CAS  Google Scholar 

  • Goldhammer E, Tanchilevitch A, Maor I, Beniamini Y, Rosenschein U, Sagiv M (2005) Exercise training modulates cytokines activity in coronary heart disease patients. Int J Cardiol 100:93–99

    Article  PubMed  Google Scholar 

  • Goodpaster B, Thaete F, Kelley D (2000) Thigh adipose tissue distribution is associated with insulin resistance in obesity and in type 2 diabetes mellitus. Am J Clin Nutr 71(4):885–892

    PubMed  CAS  Google Scholar 

  • Kalantar-Zadeh K (2006) The latest addition to the inflammatory homeboys in chronic kidney disease: interleukin-8. Nephon Clin Pract 102:c59–c60

    Article  Google Scholar 

  • Kalantar-Zadeh K (2007) Inflammatory marker mania in chronic kidney disease: pentraxins at the crossroad of universal soldiers of inflammation. Clin J Am Soc Nephrol 2:872–875

    Article  PubMed  CAS  Google Scholar 

  • Kalantar-Zadeh K, Kilpatrick R, Kuwae N, McAllister C, Alcorn H, Kopple J et al (2005) Revisiting outcome predictability of serum albumin in hemodialysis patients: time dependency, changes over time and population atributable fraction. Nephrol Dial Transplant 20:1880–1888

    Article  PubMed  Google Scholar 

  • Larsen A, Aukrust P, Aarsland T, Dickstein K (2001) Effect of aerobic exercise training on plasma levels of tumour necrosis factor alpha in patients with heart failure. Am J Cardiol 88:805–808

    Article  PubMed  CAS  Google Scholar 

  • LeMaitre J, Harris S, Fox K, Denvir M (2004) Change in circulating cytokines after 2 forms of exercise training in chronic stable heart failure. Am Heart J 147(1):100–105

    Article  PubMed  CAS  Google Scholar 

  • Nassis G, Papantakou K, Skenderi K, Triandafillopolou M, Kavouras S, Yannakoulia M et al (2005) Aerobic exercise training without changes in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls. Metab Clin Exp 54:1472–1479

    PubMed  CAS  Google Scholar 

  • Nicklas B, Ambrosius W, Messier S, Miller G, Penninx B, Loeser R et al (2004) Diet-induced weight loss, exercise and chronic inflammation in older, obese adults: a randomized controlled clinical trial. Am J Clin Nutr 79:544–551

    PubMed  CAS  Google Scholar 

  • Panichi V, Taccola D, Rizza G, Consani C, Ghiadoni L, Filippi C et al (2006) Interleukin-8 is a powerful prognostic predictor of all-cause and cardiovascular mortality in dialytic patients. Nephron Clin Pract 102(2):c51–c58

    Article  PubMed  CAS  Google Scholar 

  • Pedersen B, Toft A (2000) Effects of exercise on lymphocytes. Br J Sports Med 34:246–251

    Article  PubMed  CAS  Google Scholar 

  • Petersen A, Pedersen B (2005) The anti-inflammatory effect of exercise. J Appl Physiol 98:1154–1162

    Article  PubMed  CAS  Google Scholar 

  • Price CP, Trull AK, Berry D, Gorman EG (1987) Development and validation of a particle-enhanced turbidimetric immunoassay for C-reactive protein. J Immunol Methods 99(2):205–211

    Article  PubMed  CAS  Google Scholar 

  • Rahimi K, Secknus M, Adam M, Hayerizadeh B, Fiedler M, Thiery J et al (2005) Correlation of exercise capacity with high sensitivity C-reactive protein in patients with stable coronary artery disease. Am Heart J 150:1282–1289

    Article  PubMed  CAS  Google Scholar 

  • Rall L, Roubenoff R, Cannon J, Abad L, Dinarello C, Meydani S (1996) Effects of progressive resistance training on immune response in aging and chronic inflammation. Med Sci Sports Exerc 28(11):1356–1365

    PubMed  CAS  Google Scholar 

  • Rao M, Guo D, Perianayagam M, Tighiouart H, Jaber B, Pereira B et al (2005) Plasma interleukin-6 predicts cardiovascular mortality in hemodialysis patients. Am J Kidney Dis 45(2):324–333

    Article  PubMed  CAS  Google Scholar 

  • Roubicek T, Bartlova M, Krajickova J, Haluzikova D, Mraz M, Lacinova Z et al (2009) Increased production of proinflammatory cytokines in adipose tissue of patients with end-stage renal disease. Nutrition 25(7–8):762–768

    Article  PubMed  CAS  Google Scholar 

  • Shlipak M, Fried L, Cushman M, Manolio T, Peterson M, Stehman-Breen C et al (2005) Cardiovascular mortality risk in chronic kidney disease. JAMA 293(14):1737–1745

    Article  PubMed  CAS  Google Scholar 

  • Shoelson S, Lee J, Goldfine A (2006) Inflammation and insulin resistance. J Clin Invest 116(7):1793–1801

    Article  PubMed  CAS  Google Scholar 

  • Stenvinkel P (2002) Inflammation in end-stage renal failure: could it be treated? Nephrol Dial Transplant 17(Supplement 8):33–38

    Article  PubMed  Google Scholar 

  • Stewart L, Flynn M, Campbell W, Craig B, Robinson J, Timmerman K et al (2007) The influence of exercise training on inflammatory cytokines and C-reactive protein. Med Sci Sports Exerc 39(10):1714–1719

    Article  PubMed  CAS  Google Scholar 

  • Thompson D, Markovitch D, Betts J, Mazzatti D, Turner J, Tyrell R (2010) Time course of changes in inflammatory markers during a 6-mo exercise intervention in sedentary middle-aged men: a randomized controlled trial. J Appl Physiol 108:769–779

    Article  PubMed  CAS  Google Scholar 

  • Wanner C, Metzger T (2002) C-reactive protein a marker for all-cause and cardiovascular mortality in haemodialysis patients. Nephrol Dial Transplant 17(Supplement 8):29–32

    Article  PubMed  CAS  Google Scholar 

  • White L, Castellano V, McCoy S (2006) Cytokine responses to resistance training in people with multiple sclerosis. J Sports Sci 24(8):911–914

    Article  PubMed  Google Scholar 

  • Wisse B (2004) The inflammatory syndrome: the role of adipose tissue cytokines in metabolic disorders linked to obesity. J Am Soc Nephrol 15:2792–2800

    Article  PubMed  CAS  Google Scholar 

  • Yeh S, Marandi M, Thode H, Levine D, Parker T, Dixon T et al (2010) Report of a pilot, double-blind, placebo-controlled study of megestrol acetate in elderly dialysis patients with cachexia. J Renal Nutr 20(1):52–62

    Article  CAS  Google Scholar 

  • Yesavage J, Brink T, Rose T, Lum OJ (1983) Development and validation of a geriatric depression screening scale: a preliminary report. Psychiat Res 17:37–49

    CAS  Google Scholar 

  • Yeun J, Levine R, Mantadilok V, Kaysen G (2000) C-Reactive protein predicts all-cause and cardiovascular mortality in hemodialysis patients. Am J Kidney Dis 35(3):469–476

    Article  PubMed  CAS  Google Scholar 

  • Yudkin J, Kumari M, Humphries S, Mohamed-Ali V (2000) Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link? Atherosclerosis 148(2):209–214

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors sincerely thank all of the participants for their dedication to this research project. This investigation was enhanced through the valuable contributions of Dr. Rob Herbert, Dr. Masashi Shibata, Tanya Newton, Scott Cuthbert, Robert Russell, Michael Russo, Andrea Pantoja, Andrew Kilday, Gary Osborne, Alicia Morris, Kylie Simpson, Belinda Stewart, Samantha Tang, Keith Westbury and SEALS Pathology, Tracy Blow and the nursing staff of the St. George Public Hospital Hemodialysis Unit, Kay Cook and the staff of the Radiology Department at Royal Prince Alfred Hospital.

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  1. Birinder Singh Bobby Cheema

    Present address: School of Biomedical and Health Sciences and Family and Community Health (FaCH) Research Group, University of Western Sydney, Locked Bag 1797, Penrith South DC, Sydney, NSW, 1797, Australia

Authors and Affiliations

  1. Exercise, Health and Performance Research Group, School of Sport and Exercise Science, University of Sydney, Cumberland Campus, East Street, Lidcombe, Sydney, NSW, 2141, Australia

    Birinder Singh Bobby Cheema, Haifa Abas, Benjamin C. F. Smith, Brad Lloyd & Maria A. Fiatarone Singh

  2. Department of Medicine, St. George Hospital, University of New South Wales, Clinical Sciences Building, 2nd Floor Pitney Building, Kogarah, Sydney, 2217, Australia

    Anthony J. O’Sullivan

  3. Department of Nutrition and Dietetics, St. George Hospital, Kogarah, NSW, 2217, Australia

    Maria Chan & Glen Pang

  4. Department of Renal Medicine, St. George Hospital, Kogarah, NSW, 2217, Australia

    John Kelly

  5. Department of Nutrition and Dietetics, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia

    Aditi Patwardhan

  6. Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia

    Adrian Gillin

  7. Institute of Epidemiology and Social Medicine, University of Muenster, Domagkstr. 3, 48129, Muenster, Germany

    Klaus Berger

  8. Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, 5005, Australia

    Bernhard T. Baune

  9. Sydney Medical School, University of Sydney, Sydney, Australia

    Maria A. Fiatarone Singh

  10. Hebrew Senior Life and Jean Mayer USDA Human Nutrition Center on Aging, Tufts University, Boston, MA, USA

    Maria A. Fiatarone Singh

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  1. Birinder Singh Bobby Cheema
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Correspondence to Birinder Singh Bobby Cheema.

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Communicated by William Kraemer.

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Cheema, B.S.B., Abas, H., Smith, B.C.F. et al. Effect of resistance training during hemodialysis on circulating cytokines: a randomized controlled trial. Eur J Appl Physiol 111, 1437–1445 (2011). https://doi.org/10.1007/s00421-010-1763-5

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