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23.02.2022 | Nephrology - Original Paper

Effect of an aerobic and strength exercise combined program on oxidative stress and inflammatory biomarkers in patients undergoing hemodialysis: a single blind randomized controlled trial

verfasst von: Erika Meléndez-Oliva, Isabel Sánchez-Vera Gómez-Trelles, Eva Segura-Orti, Borja Pérez-Domínguez, Rafael García-Maset, Alicia García-Testal, Jose Luis Lavandera-Díaz

Erschienen in: International Urology and Nephrology | Ausgabe 9/2022

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Abstract

Background

Chronic kidney disease patients on hemodialysis treatment are characterized by increased levels of inflammatory markers and oxidative stress, in addition to a significant deterioration in physical function. The benefits of physical exercise on the functional capacity of this patients are well known; however, it can also improve the endogenous antioxidant defense system and the inflammatory state, but still very few studies have been carried out. This is the first study to analyze the effect of a 4-month exercise program with combined aerobic and strength training in patients undergoing hemodialysis, under two modalities.

Methods

Seventy-one patients undergoing hemodialysis were enrolled and randomized in two groups, one of them performing an intra-dialysis exercise program (n = 36), and the other carrying out a home-based exercise program (n = 35). Serum levels of oxidative stress and inflammation biomarkers were determined before and after the intervention.

Results

IL-6 plasma levels showed a significant decrease in the intra-dialysis group after exercise (42.61 ± 9.21 to 26.40 ± 7.84, p = 0.03), while CRP levels decreased significantly in the home-based group (16.12 ± 24.18 to 8.50 ± 11.28, p = 0.03). MCP-1, TNF-α, ICAM-1 and the oxidative stress markers MDA, GSH and GSSG, did not undergo significant changes after the intervention.

Conclusion

Four months of combined strength and aerobic endurance exercise improve the inflammatory status of hemodialysis patients by significantly reducing IL-6 levels in those subjects who perform intra-dialysis exercise and CRP levels in those who do it at home.
Literatur
3.
Zurück zum Zitat Bergström J, Lindholm B, Lacson E, Owen W, Lowrie EG, Glassock RJ, Ikizler TA, Wessels FJ, Moldawer LL, Wanner C, Zimmermann J (2000) What are the causes and consequences of the chronic inflammatory state in chronic dialysis patients? Semin Dial 13:163–175CrossRef Bergström J, Lindholm B, Lacson E, Owen W, Lowrie EG, Glassock RJ, Ikizler TA, Wessels FJ, Moldawer LL, Wanner C, Zimmermann J (2000) What are the causes and consequences of the chronic inflammatory state in chronic dialysis patients? Semin Dial 13:163–175CrossRef
6.
Zurück zum Zitat Weiner DE, Tighiouart H, Amin MG, Stark PC, MacLeod B, Griffith JL, Salem DN, Levey AS, Sarnak MJ (2004) Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soc Nephrol 15:1307–1315CrossRef Weiner DE, Tighiouart H, Amin MG, Stark PC, MacLeod B, Griffith JL, Salem DN, Levey AS, Sarnak MJ (2004) Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soc Nephrol 15:1307–1315CrossRef
9.
Zurück zum Zitat Quiroga B, Marin C, Goicoechea M, Luno J, Reque J (2012) Inflammatory biomarkers in chronic kidney disease: a review. Recent Patents Biomarkers 2:131–138CrossRef Quiroga B, Marin C, Goicoechea M, Luno J, Reque J (2012) Inflammatory biomarkers in chronic kidney disease: a review. Recent Patents Biomarkers 2:131–138CrossRef
11.
Zurück zum Zitat Cibulka R, Racek J (2007) Metabolic disorders in patients with chronic kidney failure. Physiol Res 56:697–705CrossRef Cibulka R, Racek J (2007) Metabolic disorders in patients with chronic kidney failure. Physiol Res 56:697–705CrossRef
13.
Zurück zum Zitat Blake C, Codd MB, Cassidy A, O’Meara YM (2000) Physical function, employment and quality of life in end-stage renal disease. J Nephrol 13:142–149PubMed Blake C, Codd MB, Cassidy A, O’Meara YM (2000) Physical function, employment and quality of life in end-stage renal disease. J Nephrol 13:142–149PubMed
19.
20.
Zurück zum Zitat Satiler W, Malle E, Kostner GM (1998) Methodological approaches for assessing lipid and protein oxidation and modification in plasma and isolated lipoproteins. Lipoprotein Protocols 110:167–192CrossRef Satiler W, Malle E, Kostner GM (1998) Methodological approaches for assessing lipid and protein oxidation and modification in plasma and isolated lipoproteins. Lipoprotein Protocols 110:167–192CrossRef
22.
Zurück zum Zitat Gérard-Monnier D, Erdelmeier I, Régnard K, Moze-Henry N, Yadan JC, Chaudière J (1998) Reactions of 1-methyl-2-phenylindole with malondialdehyde and 4-hydroxyalkenals. Analytical applications to a colorimetric assay of lipid peroxidation. Chem Res Toxicol 11:1176–1183. https://doi.org/10.1021/tx9701790CrossRefPubMed Gérard-Monnier D, Erdelmeier I, Régnard K, Moze-Henry N, Yadan JC, Chaudière J (1998) Reactions of 1-methyl-2-phenylindole with malondialdehyde and 4-hydroxyalkenals. Analytical applications to a colorimetric assay of lipid peroxidation. Chem Res Toxicol 11:1176–1183. https://​doi.​org/​10.​1021/​tx9701790CrossRefPubMed
24.
Zurück zum Zitat Reznick AZ, Packer L (1994) Oxidative damage to proteins: spectrophotometric method for carbonyl assay. Methods Enzymol 233:357–363CrossRef Reznick AZ, Packer L (1994) Oxidative damage to proteins: spectrophotometric method for carbonyl assay. Methods Enzymol 233:357–363CrossRef
25.
Zurück zum Zitat Hissin PJ, Hilf R (1976) A fluorometric method for determination of oxidized and reduced glutathione in tissues. Anal Biochem 74:214–226CrossRef Hissin PJ, Hilf R (1976) A fluorometric method for determination of oxidized and reduced glutathione in tissues. Anal Biochem 74:214–226CrossRef
26.
Zurück zum Zitat Rauramaa R, Halonen P, Väisänen SB, Lakka TA, Schmidt-Trucksäss A, Berg A, Penttilä IM, Rankinen T, Bouchard C (2004) Effects of aerobic physical exercise on inflammation and atherosclerosis in men: the DNASCO Study: a 6-year randomized, controlled trial. Ann Intern Med 140:1007–1014CrossRef Rauramaa R, Halonen P, Väisänen SB, Lakka TA, Schmidt-Trucksäss A, Berg A, Penttilä IM, Rankinen T, Bouchard C (2004) Effects of aerobic physical exercise on inflammation and atherosclerosis in men: the DNASCO Study: a 6-year randomized, controlled trial. Ann Intern Med 140:1007–1014CrossRef
27.
Zurück zum Zitat Castaneda C, Gordon PL, Parker RC, Uhlin KL, Roubenoff R, Levey AS (2004) Resistance training to reduce the malnutrition-inflammation complex syndrome of chronic kidney disease. Am J Kidney Dis 43:607–616CrossRef Castaneda C, Gordon PL, Parker RC, Uhlin KL, Roubenoff R, Levey AS (2004) Resistance training to reduce the malnutrition-inflammation complex syndrome of chronic kidney disease. Am J Kidney Dis 43:607–616CrossRef
29.
Zurück zum Zitat Liao M-T et al (2016) Intradialytic aerobic cycling exercise alleviates inflammation and improves endothelial progenitor cell count and bone density in hemodialysis patients. Medicine (Baltimore) 95:e4134CrossRef Liao M-T et al (2016) Intradialytic aerobic cycling exercise alleviates inflammation and improves endothelial progenitor cell count and bone density in hemodialysis patients. Medicine (Baltimore) 95:e4134CrossRef
30.
Zurück zum Zitat Cheema B, Abas H, Smith B, O’Sullivan A, Chan M, Patwardhan A, Kelly J, Gillin A, Pang G, Lloyd B, Singh MF (2007) Progressive exercise for anabolism in kidney disease (peak): a randomized, controlled trial of resistance training during hemodialysis. J Am Soc Nephrol 18:1594–1601. https://doi.org/10.1681/ASN.2006121329CrossRefPubMed Cheema B, Abas H, Smith B, O’Sullivan A, Chan M, Patwardhan A, Kelly J, Gillin A, Pang G, Lloyd B, Singh MF (2007) Progressive exercise for anabolism in kidney disease (peak): a randomized, controlled trial of resistance training during hemodialysis. J Am Soc Nephrol 18:1594–1601. https://​doi.​org/​10.​1681/​ASN.​2006121329CrossRefPubMed
31.
Zurück zum Zitat Cheema BSB, Abas H, Smith BCF, O’Sullivan AJ, Chan M, Patwardhan A, Kelly J, Gillin A, Pang G, Lloyd B, Berger K, Baune BT, Fiatarone Singh MA (2011) Effect of resistance training during hemodialysis on circulating cytokines: a randomized controlled trial. Eur J Appl Physiol 111:1437–1445. https://doi.org/10.1007/s00421-010-1763-5CrossRefPubMed Cheema BSB, Abas H, Smith BCF, O’Sullivan AJ, Chan M, Patwardhan A, Kelly J, Gillin A, Pang G, Lloyd B, Berger K, Baune BT, Fiatarone Singh MA (2011) Effect of resistance training during hemodialysis on circulating cytokines: a randomized controlled trial. Eur J Appl Physiol 111:1437–1445. https://​doi.​org/​10.​1007/​s00421-010-1763-5CrossRefPubMed
34.
Zurück zum Zitat Afsar R, Shegarfy L, Shavandi N, Sanavi S (2010) Effects of aerobic exercise and resistance training on lipid profiles and inflammation status in patients on maintenance hemodialysis. Indian J Nephorol 20(4):185–189CrossRef Afsar R, Shegarfy L, Shavandi N, Sanavi S (2010) Effects of aerobic exercise and resistance training on lipid profiles and inflammation status in patients on maintenance hemodialysis. Indian J Nephorol 20(4):185–189CrossRef
35.
Zurück zum Zitat Ikizler T et al (2018) Metabolic effects of diet and exercise in patients with moderate to severe CKD: a randomized clinical trial. J Am Soc Nephrol 29(1):250–259CrossRef Ikizler T et al (2018) Metabolic effects of diet and exercise in patients with moderate to severe CKD: a randomized clinical trial. J Am Soc Nephrol 29(1):250–259CrossRef
36.
Zurück zum Zitat Moraes C et al (2014) Resistance exercise: a strategy to attenuate inflammation and protein-energy wasting in hemodialysis patients? Int Urol Nephrol 46(8):1655–1662CrossRef Moraes C et al (2014) Resistance exercise: a strategy to attenuate inflammation and protein-energy wasting in hemodialysis patients? Int Urol Nephrol 46(8):1655–1662CrossRef
37.
Zurück zum Zitat Barreto D et al (2010) Plasma interleukin-6 is independently associated with mortality in both hemodialysis and pre-dialysis patients with chronic kidney disease. Kidney Int 77(6):550–556CrossRef Barreto D et al (2010) Plasma interleukin-6 is independently associated with mortality in both hemodialysis and pre-dialysis patients with chronic kidney disease. Kidney Int 77(6):550–556CrossRef
38.
Zurück zum Zitat Böhm J et al (2017) Acute effect of intradialytic aerobic exercise on solute removal, blood gases and oxidative stress in patients with chronic kidney disease. J Bras Nefrol 39(2):172–180CrossRef Böhm J et al (2017) Acute effect of intradialytic aerobic exercise on solute removal, blood gases and oxidative stress in patients with chronic kidney disease. J Bras Nefrol 39(2):172–180CrossRef
39.
Zurück zum Zitat Luengo P et al (2009) Validation of alternative anthropometric indexes as cardiovascular risk markers. Endocrinol Nutr 56(9):439–446CrossRef Luengo P et al (2009) Validation of alternative anthropometric indexes as cardiovascular risk markers. Endocrinol Nutr 56(9):439–446CrossRef
Metadaten
Titel
Effect of an aerobic and strength exercise combined program on oxidative stress and inflammatory biomarkers in patients undergoing hemodialysis: a single blind randomized controlled trial
verfasst von
Erika Meléndez-Oliva
Isabel Sánchez-Vera Gómez-Trelles
Eva Segura-Orti
Borja Pérez-Domínguez
Rafael García-Maset
Alicia García-Testal
Jose Luis Lavandera-Díaz
Publikationsdatum
23.02.2022
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 9/2022
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-022-03146-z

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