Metabolic effects of exercise training in hemodialysis patients

Abstract

The effects of 9 +/- 6 months of exercise training on lipid and carbohydrate metabolism were studied in six hemodialysis patients. Training lowered triglyceride levels 39 +/- 25% (P less than 0.02) and increased plasma high-density lipoprotein cholesterol levels 23 +/- 22% (before, 26 +/- 5 mg/dl; after, 31 +/- 8 mg/dl; P less than 0.05). There was a 23% improvement in glucose tolerance (P less than 0.01) and a 40% reduction in hyperinsulinism (P less than 0.01) with no significant changes in body weight or diet. There was a 25 +/- 8% increase in hematocrits (before, 22 +/- 2%; after, 27 +/- 2%, P less than 0.01) and a 29 +/- 2% rise in hemoglobin concentrations (before, 7.0 +/- 0.8 g/dl; after, 9.0 +/- 0.6 g/dl, P less than 0.04) in five patients. In addition, during training antihypertensive medications could be reduced in three patients with maintenance of normal blood pressure. The improvements in lipid and carbohydrate metabolism diminished when two patients stopped training. These results suggest that physical training can improve some of the metabolic abnormalities observed in hemodialysis patients and could be important as a therapeutic modality.

Physical Activity in ESRD

“…These studies have generally been conducted among the general population, and the few studies conducted among renal disease patients relied on self-reported rather than directly measured activity. Increasing physical activity has a number of well described beneficial physiologic effects on cardiorespiratory fitness, endothelial function (11), BP (12), dyslipidemia (13), muscle strength, and inflammation (14), among others. These effects offer plausible biologic pathways to explain the relationship of greater physical activity with lower risk of mortality.…”

Resultados de un programa de ejercicio físico combinado con electroestimulación neuromuscular en pacientes en hemodiálisis

“…Entre las características de todos ellos, destaca la gran heterogeneicidad de los mismos, fundamentalmente en cuanto al tipo y duración del ejercicio realizado así como a los distintos estudiajes del paciente renal; si bien es cierto que la gran mayoría de los estudios se centran en la realización de ejercicio físico de predominio aeróbico durante las sesiones de HD. A pesar de ésta mencionada diversidad, la práctica totalidad de los estudios ponen de manifi esto los efectos benefi ciosos del ejercicio físico sobre la fuerza muscular y la capacidad funcional y los aspectos psicológicos (1)(2)(3)(4)(5)(6) .…”

“…Desde entonces hasta hoy, todos los estudios refi eren benefi cios del ejercicio en este tipo de pacientes tanto a nivel fi siológico, como funcional o psicológico (3)(4)(5)(6) . A pesar de todo, la implantación de programas de ejercicio en unidades de HD no está generalizada.…”

Cardiac Rehabilitation and Survival of Dialysis Patients after Coronary Bypass

“…Improvements in HD patients' physical fitness as measured by reaction time and lower extremity muscle strength (16), left ventricular systolic function (17), and psychosocial functioning (18) have been demonstrated in randomized clinical trials. Other studies of exercise interventions in patients who were on HD have provided evidence to support improvement in arterial stiffness (19), decrease in pulse pressure (20), increase in aerobic capacity (21)(22)(23)(24)(25)(26), reduced need for antihypertensive medications (23,27,28), increase in hemoglobin concentration and hematocrit levels (28), and improved lipid metabolism (28). Started HD in hospital-based facility (%) 29.6 a CABG, coronary artery bypass grafting; HD, hemodialysis; AMI, acute myocardial infarction; COPD, chronic obstructive pulmonary disease.…”