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

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.

Effects of acute resistance exercise on acyl-ghrelin and obestatin levels in hemodialysis patients: a pilot study

“…[4][5][6] Strategies have been proposed to reverse the anorexia and, physical activity may be beneficial to increase appetite in CKD patients. 7 Studies about the effects of exercise on acyl-ghrelin and obestatin in CKD patients are scarce. A study of our group showed that 6 months of resistance exercise in hemodialysis (HD) patients was effective in reducing obestatin and increasing acyl-ghrelin levels.…”

Effects of intradialytic exercise on systemic cytokine in patients with chronic kidney disease

“…They did not observed any changes in the levels of TNF-a, IL-1b or C-reactive protein. 27,28 Nonetheless, there was an enhancement of functional capacity through aerobic exercise which was associated with the reduction of inflammatory state in CKD, and can be a secondary effect of rehabilitation programs. 29 Some limitations of this study should be mentioned: the relatively small sample size may lead to a statistical type I error; and the intensity of the exercise in EX session was performed using perceived exertion, which might affect adversely the control of the exercise.…”

Progressive Resistance Training in End-Stage Renal Disease: Systematic Review

“…Further, one RCT [49] noted no change in other pro-and anti-inflammatory cytokines, including IL-1b, IL-8, IL-10, and IL-12 secondary to 12 weeks of intradialytic PRT versus control.…”

“…Intervention duration ranged from 8 weeks to 6 months. Four trials prescribed PRT outside of dialysis time [28,29,34,35,42,49], while 12 trials prescribed PRT during dialysis [26, 27, 29-32, 34, 35, 37-41, 48, 49] .…”