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Respiratory muscle impairment in dialysis patients: can minimal dose of exercise limit the damage? A Preliminary study in a sample of patients enrolled in the EXCITE trial

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Abstract

Aim

Skeletal muscle atrophy and dysfunction with associated weakness may involve the respiratory muscles of dialysis patients. We evaluated the effect of moderate-intensity exercise on lung function and respiratory muscle strength.

Methods

Fifty-nine patients (25 F, aged 65 ± 13 years) from two centers participating in the multicenter randomized clinical trial EXerCise Introduction To Enhance Performance in Dialysis (EXCITE) were studied. Subjects were randomized into a prescribed exercise group (E), wherein subjects performed two 10-min walking sessions every second day at an intensity below the self-selected speed, or a control group (C) with usual care. Physical performance was assessed by the 6-min walk test (6MWT). Patient lung function and respiratory muscle strength were evaluated by spirometry and maximal inspiratory pressure (MIP), respectively.

Results

Forty-two patients (14 F) completed the study. At baseline, the groups did not differ in any parameters. In total, 7 patients (4 in E; 3 in C) showed an obstructive pattern. The pulmonary function parameters were significantly correlated with 6MWT but not with any biochemical measurements. Group E safely performed the exercise program. At follow-up, the spirometry parameters did not change in either group. A deterioration of MIP (−7 %; p = 0.008) was observed in group C, but not in group E (+3.3 %, p = ns). In E, an increase of 6MWT was also found (+12 vs. 0 % in C; p = 0.038).

Conclusion

In dialysis patients, a minimal dose of structured exercise improved physical capacity and maintained a stable respiratory muscle function, in contrast to the control group where it worsened.

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Acknowledgments

This work was partly supported by an Italian government Grant from the Health Minister (Ricerca Finalizzata).

Author information

Author notes

  1. Luca Pomidori, Enrico Pozzato & Michele Felisatti

    Present address: Esercizio Vita ONLUS, Via Don Giovanni Calabria 13, 44124, Ferrara, Italy

  2. Anna Maria Malagoni

    Present address: Unit of Translational Surgery, Hospital University of Ferrara, Ferrara, Italy

Authors and Affiliations

  1. Biomedical Sport Studies Centre, University of Ferrara, Ferrara, Italy

    Luca Pomidori, Anna Maria Malagoni, Enrico Pozzato, Michele Felisatti & Annalisa Cogo

  2. Department of Biomedical and Surgical Specialties Sciences, Section of Sport Sciences, University of Ferrara, Ferrara, Italy

    Nicola Lamberti, Fabio Manfredini & Annalisa Cogo

  3. Nephrology Dialysis Unit, Hospital University of Ferrara, Ferrara, Italy

    Luigi Catizone & Antonio Barillà

  4. Nephrology Dialysis Unit, Civil Hospital of Imola, Imola, Italy

    Alessandro Zuccalà

  5. CNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy

    Giovanni Tripepi & Francesca Mallamaci

  6. Nephrology and Renal Transplantation Division, Ospedali Riuniti, Reggio Calabria, Italy

    Francesca Mallamaci & Carmine Zoccali

Authors
  1. Luca Pomidori
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  2. Nicola Lamberti
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  3. Anna Maria Malagoni
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  10. Giovanni Tripepi
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  11. Francesca Mallamaci
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Corresponding author

Correspondence to Luca Pomidori.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Pomidori, L., Lamberti, N., Malagoni, A.M. et al. Respiratory muscle impairment in dialysis patients: can minimal dose of exercise limit the damage? A Preliminary study in a sample of patients enrolled in the EXCITE trial. J Nephrol 29, 863–869 (2016). https://doi.org/10.1007/s40620-016-0325-2

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