to Exercise in Physiological and Pathological condition, Clermont Ferrand, FRANCE Introduction and Aims: The aim of the study was to measure the effect of a 3-month High-Intensity Interval Training (HIIT) program on physical functioning, metabolic profile and quality of life in peritoneal dialysis (PD) patients. Methods: Twelve patients (age of 63,89 ± 2,81 years; BMI of 29,42 ± 1,66) were randomly assigned to exercise (EX; n= 8) or control (CON; n= 4) group. The trained patients performed two bicycle-HIIT sessions per week during 12 weeks. HIIT protocol consisted of repeated 8s of sprinting and 12s of turning the pedals over slowly throughout 20 min for a maximum of 60 repeats a session. The HIIT session was followed by 15 min of stretching. Physical functioning ( peak oxygen uptake and the 6-minute walk test (6MWT)), lipid profile (triglycerides (TG), total cholesterol, high-density lipoprotein, and low-density lipoprotein (LDL)), hemoglobin (Hb) and inflammatory status (CRPus, TNF-α, IL-6, IL-10) were measured before, after the intervention program and 3 months after the end of the intervention program. Energy intake, physical activity level and the quality of life were also evaluated using questionnaires (food questionnaire, IPAQ, SF-36). Results: A significant improvement of 6MWT and improvement of VO 2 peak were observed in the EX group (+ 20% and + 12%, respectively). Lipid profile was not enhanced in the EX group and may be explained by constant levels of energy intake and daily living physical activity. Hemoglobin did not change after the 3-month program in CON or EX group but the mean dose of Erythropoietin Stimulating Agent was reduced in the EX group (-95% against 6% in the CON group). Plasma CRPus, IL-6 and TNF-α levels decreased in the EX group after the HIIT program but remained stable in the CON group. Three months after the intervention program, IL-6 and TNF-α decrease and come back at their initial (M0) value. Plasma IL-10 levels were not altered in any groups. In the EX group, Quality of life was improved for the items representing physical pain limitations (+22,39%), mental pain limitations (+6,25%), relationships (+6,67%) and general health (+2,6%). Conclusions: Our study is the first to demonstrate that a 3-month HIIT program is effective in PD patients to improve physical functioning, inflammation and certain items associated with the quality of life. HIIT appears as a time-efficient strategy and could be proposed in PD patients as an alternative to the classical moderate intensity continuous training (MICT).

BACKGROUND AND AIMS The regular measurement of the haemodialysis vascular access (VA) flow demonstrates a protective effect over thrombotic complications [1]. Transonic® Ultrasound dilution technique was first introduced in 1995 and progressively became a method of reference for recirculation and blood flow measurement on haemodialysis VA [2]. It is based on the technique of haemodilution with a certain volume of 0.9% NaCl and the measure of recirculation with inversed lines using the ultrasound technique. Consecutively the VA flow is estimated with a certain formula. Nikisso DBB-EXA™ dialysis machine has the capacity to measure the VA recirculation rate by photometry performing a controlled rise on ultrafiltration rate. The aim of the present study is to compare the VA flow rate between the Transonic® Ultrasound dilution technique and the Nikisso DBB-EXA™ Ultrafiltration method. METHOD The primary outcome of the study is the association of VA flow measured by Transonic® and the Nikisso DBB-EXA™. During the first half of the same dialysis session, we measured the VA recirculation and flow rate twice with the two methods under a constant dialysis blood pump flow of 250–300 mL/min with the ultrafiltration and haemodiafiltration interrupted during the procedure after having reversed the dialysis lines. RESULTS The values are represented as mean ± SD. A total of 18 chronic haemodialysis patients (13 male: 5 female, mean age: 70 ± 14 years) participated in the study. They were haemodynamically stable without acute clinical conditions and were dialysed with a well-functioning arteriovenous fistula for at least 6 months. The mean value of recirculation with inverted dialysis lines for the Transonic® method was 20.79 ± 7.58% and for the Nikisso DBB-EXA™ was 24.43 ± 7.77. The mean values of VA blood flow with the Transonic® method were 1229 ± 588 mL/min and for the Nikisso DBB-EXA™ 1096 ± 490 mL/min. The measured values of the two methods presented a significant positive correlation (by Pearson) (R = 0.920, P < 0.001) (Figure). CONCLUSION There is a significantly positive correlation concerning the VA flow measurement between the reference method of Transonic® and the Ultrafiltration method offered by the Nikisso DBB-EXA™. Larger studies are needed to confirm this correlation with an additional comparative analysis of the reproducibility of measurements.

BACKGROUND AND AIMS There is a mounting volume of evidence on the efficacy of ketoanalogues associated with low protein diets, concerning the nephroprotective effects in patients with advanced chronic kidney disease (CKD). The important number of capsules daily ingested associated with their important calcium content would potentially affect the bone mineral metabolism of this group of patients. The aim of this study is to investigate the effects of ketoanalogues on the evolution of the bone mineral metabolism parameters in patients with advanced CKD. METHOD This is a prospective non-randomized controlled comparative study of two groups of patients. The results are shown as mean ± ESM. The first group (intervention) (20 patients, 12/8 M/F, mean age 71.9 ± 2.9, 10 with diabetes) was treated with ketoanalogues associated with a low protein diet and the control group (17 patients, 9/8 M/F, mean age 68.2 ± 3.3, 8 with diabetes) had a conventional follow-up of CKD. We studied the evolution of the body weight, renal function (glomerular filtration rate measured by the CKD-EPI formula in mL/min/1.73 m2), 24 h proteinuria, salt and protein consumption, serum albumin, serum prealbumin, alkaline reserve, serum phosphate levels, serum parathormone levels and calcium levels corrected for serum albumin at baseline as well as 6, 12 and 24 months post-inclusion. We performed a T-test for independent groups in order to study the differences between the two groups in every time point of the study. P-values < 0.05 were considered statistically significant. RESULTS The results are shown in the Table 1. There were no differences between the two groups at baseline. There was a significant nephroprotective effect of the ketoanalogues after 12 and 24 months. Alkaline reserve and serum calcium levels were significantly higher in the intervention group after 6, 12 and 24 months. Serum phosphate and serum parathormone levels were significantly higher in the control group 6 months, 1 and 2 years after the baseline. All patients were treated with the appropriate agents for the correction of the perturbed study parameters. During the 2-year follow-up, four patients from the study group (two pre-emptive renal transplantations, one death from oncologic causes and one start of dialysis) and eight patients from the control group (three deaths and five dialysis initiations) quitted the study. CONCLUSION In conclusion, the treatment with ketoanalogues and low protein diet has a significantly positive impact on the bone mineral metabolism of the patients with advanced CKD. It is unknown whether this is due to the high calcium content of the capsules or from the fact that the renal function is better preserved in the intervention group