Effects of aerobic exercise and resistance training on lipid profiles and inflammation status in patients on maintenance hemodialysis

Abstract

Physical function limitation is a common disorder in chronic hemodialysis (HD) patients, relating to increased morbidity and mortality. The aim of this study was to determine the effects of aerobic and resistance trainings on blood lipids and inflammation status in HD patients. Out of 30 volunteer males who had been undergoing conventional maintenance HD within an HD unit in Tehran, 21 subjects were enrolled. They were randomly assigned into aerobic exercise group – resistance training group undergoing an 8-week intradialytic exercise program (three times/week) and control group (n = 7, each). Training program consisted of 10-30 min stationary cycling at an intensity of 12–16 out of 20 at the rate of perceived exertion (RPE) of Borg scale in aerobic group and using ankle weights for knee extension, hip abduction and flexions at an intensity of 15–17 out of 20 at the RPE of Borg scale in resistance group. Fasting blood samples for serum biochemistry were drawn at baseline and 8 weeks. The age, HD duration, and physical activity score were 51.6±18.9yrs; 25.1±13.9 mo, and 19.2±7.6, respectively. Diabetes mellitus (43%), hypertension (28%), and obstructive uropathy (14%) were the most common underlying diseases. Aerobic and resistance exercises were correlated with serum creatinine (P< 0.0001 and P<0.001) and hs-CRP levels (P=0.005 and P=0.036) reduction so that aerobic exercise induced more reduction. These exercises had no influence on weight, Kt/V values, serum urea, albumin, hemoglobin, and lipid levels (P>0.05). Both intradialytic aerobic and resistance exercises showed beneficial effects on inflammation status without any influences on serum lipid levels probably due to short duration of the study which was not accompanied with body weight changes. Solute removal had no change during exercise programs. There is a need for more investigation on the role of exercise in HD patients.

Impact of intradialytic exercise intensity on urea clearance in hemodialysis patients

“…The impact of IDE on Kt/V is inconsistent in the literature, with both positive (Kong et al 1999;Parsons et al 2006) and no changes reported (Afshar et al 2010;Kirkman et al 2013). Compared with the control session, Kt/V was found to be slightly, but significantly greater during the 55% protocol, but not during the 70% protocol.…”

“…Intradialytic exercise (IDE) as a therapy for HD patients is utilized in few North American dialysis programs. Benefits of IDE for patients include improvements in aerobic capacity (V O 2peak ) (Ouzouni et al 2009), leg muscle strength (Chen et al 2010), quality of life (Ouzouni et al 2009), as well as lower markers of inflammation (Afshar et al 2010) and hospital usage (Parker et al 2015).…”

Intradialytic Exercise in Hemodialysis Patients: A Systematic Review and Meta-Analysis

“…From 1,706 potential studies, 24 RCTs [3,4,5,6,7,8,9,10,11,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32] fulfilled the inclusion criteria. Kouidi et al published two duplicated studies in different magazines [3,17].…”

“…Kouidi et al published two duplicated studies in different magazines [3,17]. Two studies conducted both aerobic exercise and resistance exercise training; the data were extracted separately [7,20]. A flow diagram of search and selection is shown in figure 1.…”

“…Exercise has been shown to have benefits on the potential improvements on cardiovascular outcomes [3], dialysis efficacy [4], physical function [5], health-related quality of life [6,] and hs-CRP [7]. There are three alternatives for dialysis patients, including exercise during HD, on non-dialysis days and at home.…”