Blood Flow Restriction Training Blunts Chronic Kidney Disease Progression in Humans

Abstract

Purpose This study aimed to verify the effect of 6 months of periodized resistance training (RT) with and without blood flow restriction (BFR) in patients with stage 2 chronic kidney disease (CKD) on glomerular filtration rate (GFR), uremic parameters, cytokines, and klotho–fibroblast growth factor 23 (FGF23) axis. Methods A total of 105 subjects were randomized in three groups of 35 each: control (CTL), RT, and RT + BFR. A first visit was required for an anamnesis to evaluate the number of medications and anthropometric measurements (body weight, height, and body mass index). Muscle strength (one-repetition maximum) was assessed. Venous blood samples were collected at baseline and after 6 months of training in all patients for the analysis of markers of renal function and integrity, as well as for the determination of the inflammatory profile. Statistical significances were adopted with P < 0.05. Results Both training therapies attenuated the decline of GFR (P < 0.05). The majority of CTL patients declined to stage 3 CKD (88.5%), whereas fewer incidents were noted with RT (25.7%) and RT + BFR (17.1%). Improved uremic parameters as well as inflammation (IL-6, IL-10, IL-15, IL-17a, IL-18, and TNF-α) and klotho–FGF23 axis in RT and RT + BFR (P < 0.05) were observed. Monocyte chemoattractant protein 1 was not changed (P > 0.05) but presented a large effect size (Cohen’s d), demonstrating a propensity for improvement. Conclusion Six months of periodized RT with and without BFR in patients with stage 2 CKD attenuated the progression of the disease by maintaining GFR, improving uremic parameters, cytokine profile regulation, and klotho–FGF23 axis.

Endocrine Regulation of Extra-skeletal Organs by Bone-derived Secreted Protein and the effect of Mechanical Stimulation

“…In addition, exercise also helps in the treatment of kidney-related diseases. Resistance training for patients with stage II chronic kidney disease can improve uremia parameters and the klothof-FGF23 signaling pathway, thereby alleviating the progression of the disease ( Corrêa et al, 2021 ) ( Figure 3 ).…”

Age-related Decline in Renal Function is Attenuated in Master Athletes

“…In humans with chronic kidney disease, an attenuation of proinflammatory markers blunting the progression of this disease was observed [32]. This attenuation might be associated with a decrease in inflammation and macrophage infiltration in the kidney, attenuating renal fibrosis, as demonstrated in rodents.…”

Are Resistance Training-Induced BDNF in Hemodialysis Patients Associated with Depressive Symptoms, Quality of Life, Antioxidant Capacity, and Muscle Strength? An Insight for the Muscle–Brain–Renal Axis

“…The presented arguments are results from a relay on the available literature with speculative character. Even so, robust evidence demonstrated that RT has potent antioxidant, anti-inflammatory effects and a positive impact on the metabolism profile and muscle strength [ 12 , 14 , 28 ], which may contribute to BDNF levels enhancement, mental health, and quality of life of patients with CKD.…”

“…This study is part of a large trial registered on the Brazilian clinical trials registration: Available online: , accessed on 28 July 2021, no. RBR-3gpg5w and also registered in the World Health Organization international clinical trial registry platform: Available online: , no U1111-1237-8231 (30 July 2019) [ 12 , 13 , 14 ].…”

“…In this field, a growing body of evidence shows the effectiveness of resistance training (RT) as an additional treatment tool for patients with CKD at any stage. Recently, research showed that long-term RT performed by patients with CKD improved cardiac autonomic function, muscle strength, redox profile, and down-regulate inflammation-related markers [ 12 , 13 , 14 ]. However, whether RT can modulate BDNF in hemodialysis patients is unknown.…”