Effects of Intradialytic Resistance Exercise on Protein Energy Wasting, Physical Performance and Physical Activity in Ambulatory Patients on Dialysis: A Single‐Center Preliminary Study in a Japanese Dialysis Facility

Saitoh, Masakazu; Ogawa, Masumi; Santos, Marcelo Rodrigues dos; Kondo, Hisae; Suga, Kyôichi; Tabata, Yoichiro

doi:10.1111/1744-9987.12447

Cited by 24 publications

(25 citation statements)

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“…Some reports supposed that MAMC as a surrogate of LBM is a potential predictor of quality of life and survival of patients on maintenance HD and may be more important as a surrogate of body fat mass than TSF in predicting survival [ 10 , 27 ]. Based on this, studies on muscle-gaining interventions in patients on HD, such as intradialytic resistance exercise, were suggested for improving survival in the CKD population [ 1 , 17 , 28 ]. In addition, although some studies on the nutritional status of patients with ESRD have reported evaluation strategies and effective approaches for improving patient survival [ 25 , 29 – 33 ], clinical guidelines for improving muscle mass in patients on HD are warranted to promote better clinical outcomes in patients on HD.…”

Section: Discussionmentioning

confidence: 99%

Survival in patients on hemodialysis: Effect of gender according to body mass index and creatinine

et al. 2018

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BackgroundThe association of a higher body mass index (BMI) with better survival is a well-known “obesity paradox” in patients on hemodialysis (HD). However, men and women have different body compositions, which could impact the effect of BMI on mortality. We investigated the effect of gender on the obesity-mortality relationship in Korean patients on HD.MethodsThis study included 2,833 maintenance patients on HD from a multicenter prospective cohort study in Korea (NCT00931970). The relationship between categorized BMI and gender-specific mortality was evaluated by an adjusted Cox proportional hazard model with restricted cubic spline analyses and the Competing risk analysis. We also investigated the effect of changes in BMI over 12 months and serum creatinine level on survival in male and female patients on HD.ResultsThe mean BMI was 22.6 ± 3.3 kg/m2 and the mean follow up duration was 24.2 ± 3.4 months. The patients with the highest quintile of BMI (≥25.1 kg/m2) showed lower mortality (subdistributional hazard ratio [SHR] = 0.63, 95% confidence interval [CI] = 0.43–0.93, P = 0.019) compared with those with the reference BMI quintile. When analyzed by gender, male patients with a BMI over 25.1 kg/m2 had lower mortality risk (HR = 0.43, 95% CI = 0.25–0.75, P = 0.003); however, no significant difference was found in female patients. Increased BMI after 12 months and high serum creatinine were associated with better survival only in male patients on HD.ConclusionsBMI could be used as a risk factor for mortality in male patients on HD. However, the mortality of female patients on HD was not related with baseline and follow-up BMI. This suggests that BMI is a good surrogate marker of lean body composition, especially in male patients on HD.

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Section: Discussionmentioning

confidence: 99%

Survival in patients on hemodialysis: Effect of gender according to body mass index and creatinine

et al. 2018

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“…For example, lack of time, equipment, or place would be main a challenge of physical inactivity or exercise in dialysis patients; however, these may be overcame by exercise during dialysis sessions. Saitoh et al have recently investigated the effects of intradialytic exercise in dialysis [34]. Their preliminary results showed that intradialytic exercise was safe and improved physical activity and malnutrition.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Significance of Physical Activity in Maintenance Dialysis Patients

Kang

Young

Jeong

et al. 2017

Kidney Blood Press Res

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Background: The aim of the present study was to evaluate the effects of physical activity on various aspects in Asian dialysis patients. Methods: This was a retrospective cohort study. Study participants were recruited from 27 hospitals or dialysis centers in Korea (n = 1611). The participants were divided into 3 groups according to the degree of regular exercise: Inactive group, Intermediate group, and Active group. Results: The proportions of patients with frailty and the presence of each component decreased as physical activity increased. The presence and numbers of disabilities decreased as physical activity increased. The number of participants with a history of fall during the last 12 months was 149 (20.5%) in the Inactive group, 88 (16.9%) in the Intermediate group, and 48 (13.2%) in the Active group. Physical component scale and mental component scale scores increased as physical activity increased. The survival rate for all-cause death at 500 days was 95.5% in the Active group, 95.2% in the Intermediate group, and 93.5% in the Inactive group. Conclusion: High physical activity was associated with favorable results for most health-related quality of life scale scores, including frailty, disability, and exhaustion, in Korean dialysis patients.

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“…The criteria proposed by the International Society of Renal Nutrition and Metabolism (ISRNM) expert panel were used to classify PEW [11], which has been described elsewhere [22]. PEW was scored as the grading of 1 selected item in each of the four categories of wasting syndrome as follows: serum albumin, body mass index or unintentional weight loss, predialysis serum creatinine normalized by the body surface area (sCr/ BSA), and normalized protein nitrogen appearance (nPNA).…”

Section: Definition Of Pewmentioning

confidence: 99%

Sarcopenic obesity and its association with frailty and protein-energy wasting in hemodialysis patients: preliminary data from a single center in Japan

Saitoh

Ogawa²,

Kondo³

et al. 2019

Ren Replace Ther

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Background: This study investigated the prevalence of sarcopenia or sarcopenic obesity and their association with frailty and protein-energy wasting (PEW) in hemodialysis patients. Methods: The present study enrolled 117 adult hemodialysis patients (35% female, 64 ± 12 years old) from single units of a hemodialysis center. The patients were divided into four groups: normal, obese, sarcopenia, and sarcopenic obesity. Sarcopenia was diagnosed by Asian Working Group for Sarcopenia (AWGS) criteria, and obesity was defined as an extensive percent body fat mass greater than 40% in females and 30% in males. Skeletal muscle mass and percent fat mass were evaluated by multifrequency whole-body bioimpedance electrical analysis after a midweek dialysis session. Handgrip strength and a short physical performance battery (SPPB) were assessed before a dialysis session as indicators of muscle strength and physical performance. Moreover, participants completed the Kihon Checklist and the criteria proposed by the International Society of Renal Nutrition and Metabolism expert panel to classify frailty and PEW. We performed multivariate logistic regression analysis to identify the clinical risk of frailty and PEW in patients with sarcopenia or sarcopenic obesity. Results: Forty-six (39.3%) patients were classified as normal; 18 (15.4%), as obese; 35 (29.9%), as having sarcopenia; and 18 (15.4%), as having sarcopenic obesity. The sarcopenia or sarcopenic obesity group had significantly lower handgrip strength than the normal or obesity group (all p < 0.05). In addition, the sarcopenia and sarcopenic obesity groups had significantly lower SPPB scores than the normal group (p < 0.05, respectively). In the multivariate analysis, the sarcopenic obesity group had a significantly higher risk of frailty than the normal group in the multivariate analysis after adjusting for age and gender (OR 4.518, 95%CI 1.218-16.752, p = 0.024). However, sarcopenic obesity was not associated with a higher likelihood of PEW, and sarcopenia imposed a significantly higher risk of PEW (OR 4.272, 95%CI 1.157-15.778, p = 0.029) than that in the normal group after adjusting for confounding factors. Conclusion: Sarcopenic obesity was closely associated with frailty compared with the normal condition in HD patients. However, sarcopenic obesity was not associated with a higher likelihood of PEW.

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Effects of Intradialytic Resistance Exercise on Protein Energy Wasting, Physical Performance and Physical Activity in Ambulatory Patients on Dialysis: A Single‐Center Preliminary Study in a Japanese Dialysis Facility

Cited by 24 publications

References 25 publications

Survival in patients on hemodialysis: Effect of gender according to body mass index and creatinine

Survival in patients on hemodialysis: Effect of gender according to body mass index and creatinine

The Clinical Significance of Physical Activity in Maintenance Dialysis Patients

Sarcopenic obesity and its association with frailty and protein-energy wasting in hemodialysis patients: preliminary data from a single center in Japan

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