Acute Exercise May Exacerbate Oxidative Stress Response in Hemodialysis Patients

Abstract

Background/Aims: Hemodialyzed patients (HD) demonstrate elevated oxidative stress (OXS) levels. Exercise effects on OXS response and antioxidant status of HD was investigated in the present study. Methods: Twelve HD and 12 healthy controls (HC) performed a graded exercise protocol. Blood samples, collected prior to and following exercise, were analyzed for lactate, thiobarbituric acid-reactive substances (TBARS), protein carbonyls (PC), reduced (GSH) and oxidized glutathione (GSSG), total antioxidant capacity (TAC), catalase, and glutathione peroxidase (GPX) activity. Results: HC demonstrated higher time-to-exhaustion (41%), lactate (41%) and VO_{2 peak} (55%) levels. At rest, HD exhibited higher TBARS, PC, and catalase activity values and lower GSH, GSH/GSSG, TAC, and GPX levels. Although exercise elicited a marked change of OXS markers in both groups, these changes were more pronounced (p < 0.05) in HD patients. After adjusting for VO_{2 peak}, differences between groups disappeared. VO_{2 peak}was highly correlated with GSH/GSSG, TBARS, TAC and PC at rest and after exercise. Conclusions: These results imply that HD demonstrate higher OXS levels and a lower antioxidant status than HC at rest and following exercise. Acute exercise appears to exacerbate OXS response in hemodialyzed patients probably due to diminished antioxidant defense. However, aerobic capacity level seems to be related to OXS responses in this population.

Effects of atorvastatin on oxidative stress in chronic kidney disease

“…However, we did not find the same differences in malondialdehyde and protein carbonyls. This contrasts with previous reports in end stage kidney disease populations . However, these patients have greater levels of oxidative stress compared with earlier stages of CKD as seen in our patients.…”

Modified Lipids and Lipoproteins in Chronic Kidney Disease: A New Class of Uremic Toxins

“…As a matter of fact, SOD activity seems to be correlated with CKD stage and its activity is restored by several interventions in CKD patients (erythropoietin, vitamin E supplementation and kidney transplantation) [167,168]. Similar contradictory observations were reported for catalase activity (e.g., either lowered [169], normal [165,170] or increased [160]). Glutathione activity and concentration are lowered in CKD and are correlated with uremic toxins’ concentrations [171,172] and glomerular filtration rate (GFR).…”

“…However, some controversies still exist as many studies produced conflicting results. Total antioxidant status is decreased in CKD [160,161]. Nevertheless, the large range of techniques used for this determination and the numerous confounding factors in CKD make it difficult to interpret [8,162].…”

Sustaining a Hemodialysis Exercise Program: A Review

“…People living with end‐stage kidney disease (ESKD) on dialysis have significantly higher mortality rates (1,2) and significantly lower rates of exercise (2–22) when compared to healthy individuals. Dialysis exercise programs have been shown to improve cardiovascular risk (5,23–33), quality of life (34–51), physical function (6,34,46,47,49,52–82), muscle condition (83–92), dialysis efficacy (35,36,61,76,93–101) and can decrease indicators of depression (41,102–107), inflammatory markers (56,85,108,109), and mortality (110,111) in this population.…”