Isokinetic Muscle Strength Predicts Maximum Exercise Tolerance in Renal Patients on Chronic Hemodialysis

Diesel, Wayne; Noakes, Timothy D.; Swanepoel, Charles R.; Lambert, Michael

doi:10.1016/s0272-6386(12)80563-4

Cited by 88 publications

(51 citation statements)

References 16 publications

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“…Patients who receive dialysis are weak compared with healthy sedentary control subjects (19,(61)(62)(63)(64)(65), and it is likely that weakness is an important limitation to physical functioning in patients with kidney disease. We previously showed that muscle strength was an important predictor of gait speed in patients who were on dialysis (19), and Diesel et al (66) showed that isokinetic muscle strength was an important determinant of VO 2peak in a group of patients who were on dialysis. Therefore, it seems likely that resistance exercise training could be of benefit to these patients, and it is surprising that few studies have focused on resistance exercise training or included resistance training as part of the program.…”

Section: Resistance Exercisementioning

confidence: 99%

Exercise in the End-Stage Renal Disease Population

Johansen¹

2007

Journal of the American Society of Nephrology

282

228

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Many of the known benefits of exercise in the general population are of particular relevance to the ESRD population. In addition, the poor physical functioning that is experienced by patients who are on dialysis is potentially addressable through exercise interventions. The study of exercise in the ESRD population dates back almost 30 yr, and numerous interventions, including aerobic training, resistance exercise training, and combined training programs, have reported beneficial effects. Recently, interventions during hemodialysis sessions have become more popular and have been shown to be safe. The risks of exercise in this population have not been rigorously studied, but there have been no reports of serious injury as a result of participation in an exercise training program. It is time that we incorporate exercise into the routine care of patients who are on dialysis, but identification of an optimal training regimen or regimens, according to patient characteristics or needs, is still needed to facilitate implementation of exercise programs.

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Section: Resistance Exercisementioning

confidence: 99%

Exercise in the End-Stage Renal Disease Population

Johansen¹

2007

Journal of the American Society of Nephrology

282

228

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“…EPO often causes a large increase in hemoglobin, while the corresponding increase in peak oxygen uptake is disproportionately low (6,7). Furthermore, peak oxygen uptake is better predicted by skeletal muscle strength than by hemoglobin (7,8). These findings suggest skeletal muscle oxygen extraction, not oxygen delivery to muscle, limits exercise tolerance in many renal failure patients.…”

Section: Introductionmentioning

confidence: 99%

31P-magnetic resonance spectroscopy assessment of subnormal oxidative metabolism in skeletal muscle of renal failure patients.

1993

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In hemodialysis patients, erythropoietin increases hemoglobin, but often the corresponding increase in peak oxygen uptake is low. The disproportionality may be caused by impaired energy metabolism. 3"P-magnetic resonance spectroscopy was used to study muscle energy metabolism in 11 hemodialysis patients, 11 renal transplant recipients, and 9 controls. Measurements were obtained during rest, static hand-grip, and rhythmic handgrip; recoveries were followed to baseline. During static handgrip, there were no between-group differences in phosphocreatine (PCr), inorganic phosphate (Pi), or PCr/(PCr + Pi), although intracellular pH was higher in hemodialysis patients than transplant recipients. During rhythmic hand-grip, hemodialysis patients exhibited greater fatigue than transplant recipients or controls, and more reduction in PCr/(PCr + Pi) than transplant recipients. Intracellular pH was higher in controls than either hemodialysis patients or transplant recipients. Recoveries from both exercises were similar in all groups, indicating that subnormal oxidative metabolism was not caused by inability to make ATP. The rhythmic data suggest transplantation normalizes PCr/(PCr + Pi), but not pH. In hemodialysis patients, subnormal oxidative metabolism is apparently caused by limited exchange of metabolites between blood and muscle, rather than intrinsic oxidative defects in skeletal muscle. (J.

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“…Renal disease is known to be associated with peripheral myopathy (19). Studies have indicated the impaired function of skeletal muscle, exemplified by lower muscle oxidative capacity, correlates with the degree of renal impairment (20)(21)(22). The increased presence of CK-MB (CK-B) may indicate specific expression in newly formed (embryonic) muscle fibers as occurs in regeneration, and may serve as a useful marker of regenerating muscle fibers in pathological conditions.…”

Section: Discussionmentioning

confidence: 99%

Skeletal muscle expression of creatine kinase-B in end-stage renal disease

et al. 2004

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The tissue specificity of creatine kinase (CK-MB) has been shown not to be absolute for the myocardium. Unexplained increases of plasma creatine kinase (CK-MB) occur in patients with skeletal muscle disease, confounding the diagnosis of myocardial injury.The purpose of this study was to examine the expression of CK-B as well as of the nuclear regulatory factor MyoD by Western blot and reverse transcriptase-polymerase chain reaction (RT-PCR) techniques in skeletal muscle biopsies obtained from end-stage renal disease (ESRD) patients.Quantitation of CKMB mass demonstrated a 35-fold greater concentration in skeletal muscle from ESRD patients (n = 45) vs normal skeletal muscles (n = 10), (p < 0.01). In 22 of 45 ESRD skeletal muscles, CK-B expression was detected by Western blot analysis, molecular weight 46 kDa. In the seven CK-B Western blot positive tissues studied, one demonstrated a RT-PCR amplification product at 111 bp. In contrast, no CK-B expression was detected by either Western blot or RT-PCR in normal skeletal muscles. MyoD expression (98 bp) was found in all ESRD and normal skeletal muscles. The intensity of the MyoD expression was greatest in tissues that demonstrated a higher CKMB mass concentration.Our findings demonstrate an increase in CK-B protein expression in human skeletal muscle obtained from patients with ESRD, that may in part be controlled by an increase in expression of mRNA for CK-B. The resulting increase in CKMB mass in skeletal muscle from ESRD patients may also be regulated by alterations in expression of the nuclear regulatory protein MyD.

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Isokinetic Muscle Strength Predicts Maximum Exercise Tolerance in Renal Patients on Chronic Hemodialysis

Cited by 88 publications

References 16 publications

Exercise in the End-Stage Renal Disease Population

Exercise in the End-Stage Renal Disease Population

31P-magnetic resonance spectroscopy assessment of subnormal oxidative metabolism in skeletal muscle of renal failure patients.

Skeletal muscle expression of creatine kinase-B in end-stage renal disease

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