Resistance exercise: a strategy to attenuate inflammation and protein-energy wasting in hemodialysis patients?

Moraes, Cristiane; Marinho, Sandra Mara; Nóbrega, Antônio C.; Bessa, Bruno; Jacobson, Ludmilla Viana; Stockler‐Pinto, Milena Barcza; Silva, Wellington Seguins da; Mafra, Denise

doi:10.1007/s11255-014-0712-3

Cited by 49 publications

(58 citation statements)

References 28 publications

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“…25 Accordingly, previous results of this study showed that PEW reduced significantly in the intervention group mainly due to albumin levels, BMI and AMA. 26 Accordingly, Johansen et al 27 reported that resistance training improved quadriceps muscle area in HD patients similar to other studies with HD patients that confirmed important results about resistance training and improved knee strength, lean body mass, and physical capacity. [28][29][30] In the present study, patients who underwent RETP also improved the role physical of SF-36 after intervention while the control group did not present any changes in quality of life.…”

Section: Discussionsupporting

confidence: 62%

Effects of resistance exercise training on acyl-ghrelin and obestatin levels in hemodialysis patients

et al. 2015

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Background: Patients undergoing hemodialysis (HD) present altered levels of appetite hormones such as acyl-ghrelin (orexigenic) and obestatin (anorexigenic), which may contribute to anorexia. Physical exercise may affect these hormones and improve appetite in these patients. Objectives: The objective of this study is to evaluate the effects of a resistance exercise program in appetite hormones, body composition, and nutritional status in HD patients. Design: Intervention study with the control group. Subjects: Fifty-two patients on regular HD program were enrolled into two groups: 37 patients performed exercises (56.7% male, 45 ± 12.8 years, 57 (9-192) months on HD) and 15 patients comprised the control group (66.7% men, 50 ± 10.6 years, 57 (11-153) months on HD). Measurements: Exercise program (performed with elastic bands and ankle cuffs in both lower limbs) was supervised three times a week during 6 months (72 sessions). Patients had their blood drawn in a regular HD day after overnight fasting, before and after 6 months of exercise program. Obestatin, acyl-ghrelin, routine biochemical parameters, quality of life, and anthropometric data were collected and analyzed before and after 6 months. Results: After 6 months of exercise, obestatin levels reduced [from 3.0 ng/mL (2.3-3.4) to 1.9 ng/mL (0.6-3.4)] and acyl-ghrelin levels increased [from 21.5 pg/mL (1.3-77.7) to 37.2 pg/mL (16.7-94.1)] and the control group presented no significant differences in both plasma levels of hormones. Body composition and physical functional assessed by SF-36 and albumin levels (3.7 ± 0.3 to 3.9 ± 0.2, p50.05) improved after exercises. Conclusion: Six months of resistance exercises contributed to changes in plasma appetite hormones, body composition, and nutritional status in hemodialysis patients.

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Section: Discussionsupporting

confidence: 62%

Effects of resistance exercise training on acyl-ghrelin and obestatin levels in hemodialysis patients

et al. 2015

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“…This is in line with previous literature, where malnutrition was common among HD patients globally [40] and regionally [41]. In the previous literature, exercise appeared to improve protein energy wasting [42] and thus malnutrition. Despite the positive attitude of our sample about the importance of exercise, time allocated for the physical activity was limited, and walking was almost the only form of exercise performed.…”

Section: N (%) N (%)supporting

confidence: 92%

“…This answer was translated to a high score on the scale. Such impact of religious beliefs influencing the QOL assessment among the chronically ill has been previously reported among other cultures as well [42]. Further validation of the instrument in religious-oriented cultures is recommended.…”

Section: N (%) N (%)mentioning

confidence: 53%

Intradialytic Aerobic Exercise in the United Arab Emirates: a Descriptive Study

Salhab

Karavetian

Kooman

et al. 2018

AJNE

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Aim. Intradialytic exercise (IDE) improves hyperphosphatemia management in hemodialysis (HD) patient in addition to other clinical outcomes. The aim of the study is to present the strategies needed to integrate such a protocol in an HD unit in UAE and patients' baseline characteristics. Methods. The largest HD unit in Sharjah emirate was chosen. All eligible patients (n = 57) in the unit were included. Patients were stable adults HD patients who served as their own controls. The intervention included an aerobic low intensity IDE of 45 minutes per HD session, tailored to each patient's fitness scale (BORG scale) for 6 months. Patients were educated on the importance of exercise. Outcome measures were barriers to exercise, serum phosphorus (P), urea reduction ratio (URR), malnutrition inflammation score, quality of life (QOL using euroqol5) collected at baseline and post intervention. Results. A total of 41 patients completed the study, 61% were males and 90.2%, 53.7% and 14.6% suffered from hypertension, diabetes and cardiovascular disease, respectively. Hyperphosphatemia was prevalent among 75% of the patients with a mean of 5.76 ± 1.66 mg/dl. The mean age was 48 ± 14.37 years, BMI 24.98 ± 6.09 kg/m 2 , URR 71.88 ± 8.52%, and Kt/v 1.32 ± 1.09.The main barrier to exercise was identified to be fatigue on HD days by 58.5% of patients, followed by fear of getting hurt (36.6%). Finally, 80.4% of patients were mildly malnourished and QOL scale was 65.02% ± 18.54. Conclusion. Our study highlighted the widespread of hyperphosphatemia and malnutrition in our sample. The IDE regimen, if proven effective in future studies, could be integrated in the routine practice and may improve patients'outcomes.

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“…The patients usually cycle for 10-45 min and progressively resistance is applied to the bicycle wheels [72][73][74][75][76][77][78][79][80][81][82]. Also, resistance exercises have been applied in intradialytic exercise training programs without serious complications and induced beneficial effects on patient's muscular strength [83][84][85][86][87][88][89][90] The exercises sessions occurred at the hemodialysis centers during the first two hours of the hemodialysis treatment (table 4). According to Moore et al [41] is more safe exercise training programs to be applied during the first 2 hours because cardiac function is more stable.…”

Section: Effects Of Intradialytic Exercise Programsmentioning

confidence: 99%

Intra-Renal Hemodynamic Changes After Habitual Physical Activity in Patients with Chronic Kidney Disease

Καλτσάτου¹,

Karatzaferi²,

Mitrou³

et al. 2016

CPD

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Resistance exercise: a strategy to attenuate inflammation and protein-energy wasting in hemodialysis patients?

Abstract: Resistance exercise program for 6 months seems to be effective in reducing inflammation and PEW of HD patients. The universal trial number of this study is U1111-1139-1326.

Cited by 49 publications

References 28 publications

Effects of resistance exercise training on acyl-ghrelin and obestatin levels in hemodialysis patients

Effects of resistance exercise training on acyl-ghrelin and obestatin levels in hemodialysis patients

Intradialytic Aerobic Exercise in the United Arab Emirates: a Descriptive Study

Intra-Renal Hemodynamic Changes After Habitual Physical Activity in Patients with Chronic Kidney Disease

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