Intradialytic Cardiovascular Exercise Training Alters Redox Status, Reduces Inflammation and Improves Physical Performance in End Stage Renal Disease Patients under Hemodialysis

Background: Albumin, the most abundant protein in the extracellular fluid, displays an important antioxidant activity. Increased levels of oxidized albumin levels (high human non-mercaptoalbumin (HNA) level) have been reported in the serum of patients with end-stage renal disease. In this study, we attempted to identify the albumin redox status in the serum of patients on peritoneal dialysis (PD) and examined the relationship between these proteins and the transport type of the peritoneal membrane and other clinical and laboratory variables. Methods: We performed a cross-sectional study of a cohort of 80 patients with end-stage renal disease receiving PD. Peritoneal transport characteristics were identified and after peritoneal equilibration test patients were grouped as high (high(H)/high-average (HA) group, n = 31) or low (low (L)/low-average (LA) group, n = 49) transporters. The redox state of human serum albumin was measured using high-performance liquid chromatography. Results: The fraction of human mercaptoalbumin (HMA) showed significantly higher values in patients with high transport status than those with low transport status (f(HMA) 64.0 ± 5.4 and 52.7 ± 10.4%, respectively). Our data showed that the H/HA transport characteristic was associated with lower albumin (3.76 ± 0.48 vs. 4.00 ± 0.35, p < 0.05), and lower levels of advanced oxidized protein product (p = 0.008) when compared with the L/LA type. A correlation analysis showed that there was a positive correlation between dialysate/plasma (D/P) creatinine and f(HMA) levels (r = 0.511, p < 0.0001), as well as hemoglobin levels r = 0.231, p = 0.044 and a negative correlation between D/P creatinine and serum albumin, cholesterol and LDL levels (r = -0.236, p = 0.039; r = -0.237, p = 0.038; r = -0.272, p = 0.018, respectively). Conclusions: This study showed that higher serum levels of reduced albumin f(HMA) appear to be associated with high/high average peritoneal membrane transport characteristics in the incident PD patients.

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Effects of In-Center Resistance Training in End-Stage Renal Disease: A Pilot Study

Journal of Clinical Exercise Physiology ◽

10.31189/2165-6193-8.3.91 ◽

2019 ◽

Vol 8 (3) ◽

pp. 91-96

Author(s):

Michael Bruneau ◽

Jennifer McKinnon ◽

Michael J. Germain ◽

Tracey Matthews ◽

Thomas Dodge ◽

...

Keyword(s):

Resistance Training ◽

Renal Disease ◽

Physical Performance ◽

End Stage Renal Disease ◽

Short Form ◽

Manual Muscle Testing ◽

Muscle Testing ◽

Sf 36 ◽

Stage Renal Disease ◽

End Stage

ABSTRACT Background: Patients with end-stage renal disease are sedentary, frail, and have low functional ability (FA) compared to healthy age-matched controls. The purpose of this study was to examine the effects of an intradialytic, supervised, 8-week resistance training (RT) program on strength (ST), FA, and quality of life (QOL) in a sample of patients with end-stage renal disease. Methods: Twenty hemodialysis patients were randomized to an exercise (E, n = 12) or control (C, n = 8) group. Patients randomized to E received intradialytic RT immediately before and during treatment, 3 d per week for 8 weeks. Patients randomized to C received usual care and no exercise. ST and FA were assessed at baseline and at 4 and 8 weeks with manual muscle testing and the Short Physical Performance Battery. QOL was assessed at baseline and 8 weeks with the 36-item Short Form Health Survey (SF-36). Mixed factorial ANOVAs were used to determine the effects of RT on ST, FA, and QOL. Results: Significant interactions were found for ST for the right (p = 0.006) and left (p = 0.008) gastrocnemius, right quadriceps (p = 0.003), right (p = 0.005) and left (p = 0.004) hamstrings, and right adductor (p = 0.020). ST improved for E but not C across time (p < 0.05). Significant time effects for FA were found for chair (p = 0.001) and total (p = 0.008) SPPB scores but were not different between groups (p > 0.05). Similar effects were found for the physical performance component of the SF-36 (p = 0.023). Conclusion: A supervised 8-week, intradialytic RT program improved lower body ST in patients with end-stage renal disease; however, these improvements did not impact FA or QOL.

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Exercise training in patients with end-stage renal disease on hemodialysis: Comparison of three rehabilitation programs

Journal of Rehabilitation Medicine ◽

10.1080/165019702317242695 ◽

2002 ◽

Vol 34 (1) ◽

pp. 40-45 ◽

Cited By ~ 167

Author(s):

Erasmia Konstantinidou ◽

Georgia Koukouvou ◽

Evangelia Kouidi ◽

Asterios Deligiannis ◽

Achilleas Tourkantonis

Keyword(s):

Exercise Training ◽

Renal Disease ◽

End Stage Renal Disease ◽

Rehabilitation Programs ◽

Stage Renal Disease ◽

End Stage

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Association between physical performance and incidence of end-stage renal disease in older adults: a national wide cohort study

BMC Nephrology ◽

10.1186/s12882-021-02291-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Hee-won Jung ◽

In Young Choi ◽

Dong Wook Shin ◽

Kyungdo Han ◽

Jung Eun Yoo ◽

...

Keyword(s):

Health Insurance ◽

Renal Disease ◽

Incidence Rate ◽

Physical Performance ◽

End Stage Renal Disease ◽

Health Examination ◽

Physical Frailty ◽

Increased Risk ◽

Stage Renal Disease ◽

End Stage

Abstract Background Physical frailty has previously been associated with adverse clinical outcomes in patients with end-stage renal disease (ESRD). This study aimed to determine whether impaired physical performance at baseline is associated with the incidence of ESRD, using a nationwide database. Methods The timed up-and-go (TUG) test was used to assess physical frailty in 1,552,781 66-year-old individuals, using health examination database records from the Korean National Health Insurance Service. As a primary endpoint, incident ESRD was defined operationally using healthcare claims data from the Korean Health Insurance Review and Assessment Service. Results Our results showed that baseline kidney function was significantly worse in individuals with TUG results of > 10 s compared to individuals with an intact TUG performance (≤10 s). Kaplan-Meier analysis showed a stepwise dose-response relationship between baseline physical performance and the incidence rate of ESRD (log-rank test P-value of < 0.001). An increasing ESRD incidence rate trend with poor physical performance remained significant after adjusting for characteristics such as baseline glomerular filtration rate and proteinuria. Conclusion Poor baseline physical performance was associated with an increased risk of ESRD, suggesting possible interactions between systemic frailty and vascular aging processes.

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