Intradialytic cycling does not exacerbate microparticles or circulating markers of systemic inflammation in haemodialysis patients

Abstract

Purpose Patients receiving haemodialysis (HD) display elevated circulating microparticle (MP) concentration, tissue factor (TF) expression and markers of systemic inflammation, though regular intradialytic cycling (IDC) may have a therapeutic effect. This study investigated the impact of regular, moderate-intensity IDC on circulating MPs and inflammatory markers in unit-based HD patients. Methods Patients were cluster-randomised to intervention (n = 20, age: 51.4 ± 18.1 years, body mass: 77.6 ± 18.3 kg, mean ± SD) or no-exercise control (n = 20, 56.8 ± 14.0 years, 80.5 ± 26.5 kg). Intervention participants completed 30 min of moderate intensity (rating of perceived exertion [RPE] of 12–14) IDC, thrice weekly for 6 months. Pre-dialysis venous blood samples were obtained at 0, 3 and 6 months. Circulating MP phenotypes, cytokines, chemokine and MP TF expression were quantified using flow cytometry and cytometric bead array assays. Results Despite high exercise compliance (82%), no IDC-dependent effects were observed for any MP, cytokine or chemokine measure (p ≥ 0.051, ηρ2 ≤ 0.399) other than TNF-α (p = 0.001, ηρ2 = 0.186), though no significance was revealed upon post hoc analysis. Conclusion Six months of regular, moderate-intensity IDC had no effect on MPs, cytokines or chemokines. This suggests that the exercise did not exacerbate thrombotic or inflammatory status, though further functional assays are required to confirm this. Trial registration ISRCTN1129707, prospectively registered on 05/03/2015.

Effect of Exercise on Inflammation in Hemodialysis Patients: A Systematic Review

“…The 24 studies included were conducted in Iran [ 19 ], Brazil [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], Poland [ 30 ], the United Kingdom [ 31 , 32 , 33 , 34 , 35 , 36 ], Taiwan [ 37 ], China [ 38 ], Indonesia [ 39 ], Spain [ 40 , 41 ] and Greece [ 42 ], and published from 2010 to 2022.…”

“…The characteristics of the included studies are presented in Table 1 . The 24 studies were clinical trials, of which thirteen were randomized controlled trials [ 19 , 25 , 26 , 27 , 28 , 29 , 35 , 36 , 37 , 38 , 39 , 41 , 42 ], four were uncontrolled trials [ 20 , 21 , 30 , 40 ], one was a non-randomized clinical trial [ 23 ], one was a non-randomized controlled trial [ 32 ], four were randomized crossover trials [ 22 , 24 , 31 , 33 ], and one was a non-randomized crossover trial [ 34 ].…”

“…The methodological quality of the studies was evaluated with the PEDro scale, and scores are shown in Table 2 . In total, seventeen studies were evaluated as being of excellent quality [ 19 , 22 , 24 , 25 , 26 , 27 , 28 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 41 , 42 ], two studies were of good quality [ 23 , 29 ] and five studies were of acceptable quality [ 20 , 21 , 30 , 32 , 40 ].…”

“…In total, seventeen studies were evaluated. Five studies were at low risk of bias [ 26 , 28 , 31 , 37 , 39 ], five studies had an unclear risk [ 25 , 35 , 36 , 41 , 42 ] and seven studies were at high risk of bias [ 19 , 22 , 24 , 27 , 29 , 33 , 38 ].…”

“…One study did not find differences in IL-6 after AE [ 30 ] and three studies did not find differences after RT [ 20 , 21 , 28 ]. Additionally, no changes were found when comparing AE and RT in IL-6 levels [ 26 ] or when compared to usual care [ 31 , 32 , 35 , 36 ]. On the other hand, two studies found decreased levels of IL-6 after AE compared to usual care [ 25 , 37 ].…”