Physical training in patients on hemodialysis has a beneficial effect on the levels of eicosanoid hormone-like substances

Abstract

ObJEctIVE: the aim of this study was to evaluate the changes in the levels of vasoactive eicosanoid hormone-like substances PGE2, PGI2 and tXA2 in hemodialysis (HD) patients who were following a long-term physical training program during the hemodialysis session. DEsIGN: A total of 50 patients with chronic Kidney Disease (cKD) (stage 5) on hemodialysis and 35 healthy individuals who served as controls (c) were evaluated. the 50 cKD patients were divided into two groups: the HD group consisted of 31 patients who received usual care without any physical activity during the hemodialysis sessions, while group HD/Exer included 19 patients who followed a program of physical exercise for six months. Plasma levels of PGE2, 6-Keto-PGF1α (the stable derivative of PGI2) and tXb2 (the stable derivative of tXA2) were measured by reliable enzymo-immunoassay methods (EIA) in HD and HD/Exer patients before and after the hemodialysis sessions as well as in the group of c. rEsULts: the plasma levels of PGE2 and 6-keto-PGF1α in group HD Exer/before patients were higher than those in group HDbefore (20.39±5.82 and 1449.19±553.41 vs 17.68±5.36 and 1295.10±384.43 pg/ml, p=0.044 and p=0.067, respectively), while the plasma levels of tXb2 were lower in HD Exer/before patients compared to HDbefore(499.76±67.51 vs 608.01±80.23 pg/ml, p=0.041). the plasma levels of PGE2 and 6-keto-PGF1α in group HD Exer/after patients were significantly higher compared to those in HDafter patients (23.01±5.70 and 1618.19±435.07 vs 16.57±4.97 and 1005.44±317.16 pg/ ml, p<0.001 and p<0.040, respectively). However, significantly lower values in the plasma levels of tXb2 in HD Exer/after compared to HDafter patients (363.10±51.91 vs 439.75±62.34 pg/ml, p=0.030) were detected. As expected, PGE2 and 6-keto-PGF1α values were lower in c than in the groups of patients with cKD. cONcLUsIONs: the data indicate that exercise training during HD exerts a beneficial effect on the levels of the vasoactive eicosanoid hormone-like substances in patients on HD.

Effect of Exercise Performed during Hemodialysis: Strength versus Aerobic

“…12 One of the hypotheses attributes these results to the above 15 min' duration of exercise, which could increase the systemic and muscular blood flow, favoring the balance between prostaglandins and thromboxane hormones, which stimulates the peripheral vasodilation and promotes toxin clearance. [48][49][50] Supposedly, such metabolic alterations influence the adenosine triphosphate (ATP), phosphocreatine (PCr), and glycogen concentrations, being the substrate generators of energy for muscular contraction, and able to affect the oxidative capacity. 17,29 All of these alterations affect the HD patients' perception with respect to their quality of life (QoL), which could also improve with the practice of physical exercises, 9 decreasing the tiredness and fatigue signals and symptoms, and the cramps manifested by dialysis.…”

Anti‐inflammatory effects of linagliptin in hemodialysis patients with diabetes

“…Additionally, data are lacking about whether increased or decreased PGE2 levels are beneficial in dialysis patients. PGE2 increases after exercise in HD patients, but may also contribute to intradialysis hypotension …”

“…PGE2 increases after exercise in HD patients, but may also contribute to intradialysis hypotension. 57,58 In conclusion, the anti-inflammatory effects of linagliptin monotherapy, which may decrease PGE2 levels and alter GSIS, suggest that it is an efficacious drug for treating HD patients with diabetes and chronic inflammation. Manuscript received August 2013; revised November 2013.…”

Quality of Life of Greek Patients With End Stage Renal Disease Undergoing Haemodialysis

“…Health care workers should encourage patients to comply with the pharmaceutical treatment prescribed, as well as the diet and follow an individ‐ualised exercise programme adjusted to their personal needs and abilities. Exercise improves physical function and activities of daily living (Chen et al 2010) and appropriate diet as well as medical treatment improve cardiovascular function and keep both blood pressure and blood sugar at desirable levels (Goldberg et al 1980; Karamouzis et al 2009). Exercise appears also to improve cardiovascular function by lessening arterial hardening, which can result in decreased left ventricular overload and hypertrophy (Mustata et al 2004).…”