Benefits of Exercise Training during Hemodialysis Sessions: A Prospective Cohort Study

Mihaescu, Adelina; Avram, Claudiu; Bob, Flaviu; Gaiță, Dan; Schiller, Oana; Schiller, Adalbert

doi:10.1159/000355856

Cited by 29 publications

(38 citation statements)

References 46 publications

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“…Strategies to improve nutritional competence may include oral supplemental nutrition programs. Strategies to increase creatinine by increasing muscle mass could possibly benefit both LTI and FTI (36).…”

Section: Discussionmentioning

confidence: 99%

Body Composition and Survival in Dialysis Patients

Marcelli

Usvyat

Kotanko

et al. 2015

Clinical Journal of the American Society of Nephrology

140

115

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Background and objectives High body mass index appears protective in hemodialysis patients, but uncertainty prevails regarding which components of body composition, fat or lean body mass, are primarily associated with survival. (FTIs), which are the respective tissue masses normalized to height squared, relative to an age-and sex-matched healthy population. The relationship between LTI and FTI and all-cause mortality was studied by Kaplan-Meier analysis, multivariate Cox regression, and smoothing spline ANOVA logistic regression.Results In 37,345 hemodialysis patients, median (25th-75th percentile) LTI and FTI were 12.2 (10.3-14.5) and 9.8 (6.6-12.4) kg/m 2 , respectively. Median (25th-75th percentile) follow-up time was 266 (132-379) days; 3458 (9.2%) patients died during follow-up. Mortality was lowest with both LTI and FTI in the 10th-90th percentile (reference group) and significantly higher at the lower LTI and FTI extreme (hazard ratio [HR], 3.37; 95% confidence interval [95% CI], 2.94 to 3.87; P,0.001). Survival was best with LTI between 15 and 20 kg/m 2 and FTI between 4 and 15 kg/m 2 (probability of death during follow-up: ,5%). When taking the relation between both compartments into account, the interaction was significant (P=0.01). Higher FTI appeared protective in patients with low LTI (HR, 3.37; 95% CI, 2.94 to 3.87; P,0.001 at low LTI-low FTI, decreasing to HR, 1.79; 95% CI, 1.47 to 2.17; P,0.001 at low LTI-high FTI).Conclusions This large international study indicates best survival in patients with both LTI and FTI in the 10th-90th percentiles of a healthy population. In analyses of body composition, both lean tissue and fat tissue compartments and also their relationship should be considered.

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Section: Discussionmentioning

confidence: 99%

Body Composition and Survival in Dialysis Patients

Marcelli

Usvyat

Kotanko

et al. 2015

Clinical Journal of the American Society of Nephrology

140

115

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“…However, the study was done in a relatively small number of patients at a single center. Another prospective interventional study suggests the role of arterial stiffness: Three months of exercise training during dialysis in 19 HD patients improved aortic PWV and increased skeletal muscle mass [23].…”

Section: Discussionmentioning

confidence: 99%

Association between Urine Creatinine Excretion and Arterial Stiffness in Chronic Kidney Disease: Data from the KNOW-CKD Study

Hyun

Kim

Sung

et al. 2016

Kidney Blood Press Res

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Background/Aims: Previous studies have shown that low muscle mass is associated with arterial stiffness, as measured by pulse wave velocity (PWV), in a population without chronic kidney disease (CKD). This link between low muscle mass and arterial stiffness may explain why patients with CKD have poor cardiovascular outcomes. However, the association between muscle mass and arterial stiffness in CKD patients is not well known. Methods: Between 2011 and 2013, 1,529 CKD patients were enrolled in the prospective Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). We analyzed 888 participants from this cohort who underwent measurements of 24-hr urinary creatinine excretion (UCr) and brachial-ankle PWV (baPWV) at baseline examination. The mean of the right and left baPWV (mPWV) was used as a marker of arterial stiffness. Results: The baPWV values varied according to the UCr quartile (1,630±412, 1,544±387, 1,527±282 and 1,406±246 for the 1st to 4th quartiles of UCr, respectively, P<0.001). For each 100 mg/d increase in UCr, baPWV decreased by 6m/sec in a multivariable linear regression model fully adjusted for traditional and renal cardiovascular risk factors. The odds ratio of the 1st quartile for high baPWV (highest quintile of mPWV) compared with the 4th quartile was 2.62 (1.24-5.54, P=0.011) in a logistic model fully adjusted for traditional and renal cardiovascular risk factors. Conclusion: Low muscle mass estimated by low UCr was associated high baPWV in pre-dialysis CKD patients in Korea. Further studies are needed to confirm the causal relationship between UCR and baPWV, and the role of muscle mass in the development of cardiovascular disease in CKD.

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“…However, the effects of exercise training on arterial stiffness in elderly patient populations are contradictory [34][35][36][37][38]. This issue is further complicated by the heterogeneity among studies in modality, frequency and duration of exercise training, and in the assessment method for arterial stiffness.…”

Section: Arterial Stiffness and Systemic Inflammationmentioning

confidence: 99%

Arterial stiffness in patients with COPD: the role of systemic inflammation and the effects of pulmonary rehabilitation

et al. 2013

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Clear evidence for an association between systemic inflammation and increased arterial stiffness in patients with chronic obstructive pulmonary disease (COPD) is lacking. Moreover, the effects of pulmonary rehabilitation on arterial stiffness are not well studied.We aimed to 1) confirm increased arterial stiffness in COPD; 2) evaluate its correlates including systemic inflammation; and 3) study whether or not it is influenced by pulmonary rehabilitation.Aortic pulse-wave velocity (APWV) was determined in 168 healthy volunteers, and APWV and inflammatory markers were determined in 162 COPD patients during baseline evaluation of a pulmonary rehabilitation programme. A complete post-pulmonary rehabilitation dataset was collected in 129 patients.It was found that APWV was increased in COPD patients when compared with controls, blood pressure and age predicted baseline APWV, and systemic inflammatory markers were not independently related to APWV. Although baseline APWV was predictive for the change in APWV after pulmonary rehabilitation (r5 -0.77), on average APWV did not change (10.7¡2.7 versus 10.9¡2.5 m?s -1 ; p50.339). Arterial stiffness in COPD is not related to systemic inflammation and does not respond to state-of-theart pulmonary rehabilitation. These results emphasise the complexity of cardiovascular risk and its management in COPD. @ERSpublications Arterial stiffness in COPD is not related to systemic inflammation and does not respond to pulmonary rehabilitation

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Benefits of Exercise Training during Hemodialysis Sessions: A Prospective Cohort Study

Cited by 29 publications

References 46 publications

Body Composition and Survival in Dialysis Patients

Body Composition and Survival in Dialysis Patients

Association between Urine Creatinine Excretion and Arterial Stiffness in Chronic Kidney Disease: Data from the KNOW-CKD Study

Arterial stiffness in patients with COPD: the role of systemic inflammation and the effects of pulmonary rehabilitation

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