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

ABSTRACT

PURPOSE: Patients undergoing hemodialysis (HD) present persistent inflammation and protein-energy wasting (PEW), which contributes to high rates of mortality. This study aimed to assess the effects of a resistance exercise training program (RETP) on inflammation and PEW in HD patients. METHODS: Thirty-seven patients (56.7 % men, 45.9 ± 14.1 years, 23.5 ± 3.9 kg/m(2)) performed 6 months of intradialytic RETP. Plasma adhesion molecules levels (ICAM-1 and VCAM-1) were measured using the enzyme immunometric assay, and interleukin-6 (IL-6), C-reactive protein, and tumor necrosis factor-alpha by ELISA. Anthropometric, physical capacity, and PEW (simultaneously presence of BMI <23 kg/m(2), serum albumin <3.8 g/dL, and reduced arm muscle area) were analyzed. RESULTS: There was a reduction of ICAM-1 [(1,934.1 pg/mL (1,031.8-2,875.0) vs. 1,571.1 pg/mL (447.1-2,985.5), p < 0.05], VCAM-1 [5,259.51 pg/mL (3,967.4-6,682.4) vs. 3,062.11 pg/mL (2,034.0-5,034.4), p < 0.05], and CRP levels (2.3 ± 0.9 to 1.6 ± 0.6 pg/mL, p < 0.001) after 6 months of RETP. Body composition improved, albumin increased (3.7 ± 0.3 to 3.9 ± 0.2, p < 0.05), and the number of patients presenting PEW was decreased (p = 0.005). CONCLUSIONS: 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.