Effect of Local Physical Training on the Forearm Arteries and Veins in Patients with End-Stage Renal Disease

Abstract

Aim: We investigate the effects of local training on the forearm vessels in patients with end-stage renal disease. Methods: Fourteen hemodialysis patients were included. Handgrip training was performed for 8 weeks. The following parameters were measured at the beginning of the study and 4 and 8 weeks later: forearm circumference, maximal handgrip strength, and artery and vein parameters, including endothelium-dependent and endothelium-independent vasodilatation (using ultrasound and duplex Doppler scanning). Results: The maximal handgrip strength increased significantly. The radial artery diameters were significantly higher after 8 weeks of training. The endothelium-dependent vasodilatation was found to be significantly increased after 4 and 8 weeks of training. The maximal vein diameters increased significantly with training, with preserved distensibility. Conclusions: The present study suggests that regular handgrip training increases the diameters of forearm vessels. It also improves endothelium-dependent vasodilatation. These changes point to the possible beneficial effects of daily handgrip training in chronic renal failure patients before arteriovenous fistula construction.

Does Handgrip Exercise Training Increase Forearm Ischemic Vasodilator Responses in Patients Receiving Hemodialysis?

“…In contrast to the beneficial effects of physical training on the endothelial function and arterial and venous size in the previous studies (Kouidi et al 1998;Leaf et al 2003;Rus et al 2003) and on the muscle contraction function in the present study, 6-week handgrip training did not affect the forearm vasodilator responses. Several investigators reported the following effects of physical training on the vascular function.…”

“…The muscle endurance in the patients receiving hemodialysis was 42% of the value in the controls, and 6-week training increased the value to 163% of the value before the training. This beneficial effect of local physical training on the muscle function in the present study is consistent with the findings after local or systemic physical training in previous studies (Kouidi et al 1998;DePaul et al 2002;Headley et al 2002;Konstantinidou et al 2002;Oh-Park et al 2002;Rus et al 2003).…”

“…2 0 0 1 ; Konstantinidou et al 2002), and improves muscle contraction function (Heiwe et al 2001;Rus et al 2003) with restoration of the muscle atrophy (Kouidi et al 1998) and an increase in the number of mitochondria in the muscle fibers (Kouidi et al 1998). Furthermore, increases in the number of capillaries (Kouidi et al 1998) and in the size of forearm large arteries and veins with functional improvement of the endothelium (Leaf et al 2003;Rus et al 2003) after physical training were reported. However, it is not clear whether the vasodilator capacity is increased after physical training, although vasodilation is one of the key phenomena for blood perfusion into working skeletal muscles during exercise.…”

“…After chronic physical training, using ultrasound and duplex Doppler scanning Rus et al (2003) and Leaf et al (2003) reported that the size of forearm large arteries (Rus et al 2003) and veins (Rus et al 2003;Leaf et al 2003) was significantly increased, and that the endothelium-dependent vasodilation was improved without changes in endotheliumindependent dilation (Rus et al 2003). However, the effect of physical training on the vasodilator responses to arterial occlusion had not been clarified.…”

Physical Exercise in Patients with Severe Kidney Disease

“…A possible contributor to these beneficial effects on potassium and phosphate is the shift of these ions from the intracellular compartment into muscle interstitial fluid that occurs during exercise [64]. Furthermore, regular handgrip training increased the diameters of forearm vessels and improved endothelium- dependent vasodilatation, an effect that can be beneficial before the creation of vascular access for HD [65]. …”