Effect of Resistance Exercise Plus Cholecalciferol on Nutritional Status Indicators in Adults With Stage 4 Chronic Kidney Disease

Olvera-Soto, Guadalupe; Medina, Veronica Liliana Ruiz; Medeiros, Mara; Castillo-Martı́nez, Lilia; López-López, Carlos Omar; Fuchs-Tarlovsky, Vanessa; Monroy, Adriana; Valdez-Ortiz, Rafael

doi:10.1053/j.jrn.2019.07.007

Cited by 4 publications

(9 citation statements)

References 43 publications

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“…Martin-Alemañy et al [ 41 ] showed that the combination of oral nutritional supplementation with aerobic or resistance intradialytic exercise had better effects on physical function than supplementation alone in young HD patients. Due to the association of vitamin D status with muscle health and the high prevalence of vitamin D deficiency in CKD, Olvera-Soto et al [ 42 ] added cholecalciferol supplements to a resistance exercise program intervention in stage 4 CKD patients. A significant increase in HGS was observed.…”

Section: Discussionmentioning

confidence: 99%

Age, diabetes mellitus, and dialysis modality are associated with risk of poor muscle strength and physical function in hemodialysis and peritoneal dialysis patients

Silva

Antônio

Reis

et al. 2021

Kidney Res Clin Pract

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Background: Due to the poor outcomes associated with the impairment of physical function and muscle strength in patients on maintenance dialysis, it is important to understand the factors that may influence physical function and muscle strength. The aim of this study was to explore the factors associated with physical function in hemodialysis and peritoneal dialysis patients. Methods: Patients with chronic kidney disease on dialysis for at least 3 months, aged 18 years old or above, were enrolled. Physical function was assessed by handgrip strength, gait and sit-to-stand tests, and the Short Physical Performance Battery (SPPB). Clinical and laboratory data were collected to verify the association with physical function parameters through binary logistic regression. Results: One-hundred ninety patients on maintenance dialysis were included; 140 patients (73.7%) on hemodialysis and 50 (26.3%) on peritoneal dialysis. The mean age was 57.3 ± 14.9 years, 109 (57.4%) were male, and 87 (45.8%) were older than 60 years. The median SPPB was 8.0 points (6.0-10.0 points) and the mean ± standard deviation of handgrip strength was 24.7 ± 12.2 kg. Binary logistic regression showed that age, type of renal replacement therapy, diabetes mellitus, and serum creatinine were significantly associated with both higher 4-meter gait test times and lower SPPB scores. Only age and diabetes mellitus were associated with higher sit-to-stand test times, while age and ferritin were associated with lower handgrip strength. Conclusion: Age, diabetes mellitus, serum creatinine, and hemodialysis modality are factors related to physical function in dialysis patients.

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Section: Discussionmentioning

confidence: 99%

Age, diabetes mellitus, and dialysis modality are associated with risk of poor muscle strength and physical function in hemodialysis and peritoneal dialysis patients

Silva

Antônio

Reis

et al. 2021

Kidney Res Clin Pract

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“…We have identified only one study that prescribed RE intervention with vitamin D (non‐RCT) 68 and four studies prescribing RE with high‐protein ONS; two of which are RCTs 69,70 and two are non‐RCTs 71,72 . RE plus vitamin D examined effects in non‐dialysis CKD Stage 4 patients 68 while RE plus ONS were prescribed in dialysis patients only because high‐protein ONS is contraindicated in non‐dialysis patients 69–72 . Mean sample size of included studies is 32 (±6.7 SD ) while median duration of intervention is 12 weeks (range 12–24).…”

Section: Resistance Exercise Plus Nutritional Interventionsmentioning

confidence: 99%

“…Mean sample size of included studies is 32 (±6.7 SD ) while median duration of intervention is 12 weeks (range 12–24). All five studies investigated outcome in population <65 years of age 68–72 . Heterogeneity is evident in both the type of exercise and the nutrition interventions specifically protein content of prescribed ONS (median 39.2 g/week; range 28.4–199.2) 69–72 .…”

Section: Resistance Exercise Plus Nutritional Interventionsmentioning

confidence: 99%

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Resistance exercise and nutritional interventions for augmenting sarcopenia outcomes in chronic kidney disease: a narrative review

Noor

Reid

Slee

2021

J cachexia sarcopenia muscle

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Sarcopenia is an age‐related progressive muscle disease characterized by loss of muscle mass, muscle strength and physical performance with high prevalence in chronic kidney disease (CKD). CKD is associated with decreased muscle protein synthesis and muscle breakdown due to a number of factors including, the uremic inflammatory environment of the disease. CKD patients are highly sedentary and at risk of malnutrition which may exacerbate sarcopenia outcomes even further. Short and long‐term exercise and nutritional interventions have been studied and found to have some positive effects on sarcopenia measures in CKD. This narrative review summarized evidence between 2010 and 2020 of resistance exercise (RE) alone or combined with nutritional interventions for improving sarcopenia outcomes in CKD. Due to lack of CKD‐specific sarcopenia measures, the second European Working Group on Sarcopenia in Older People (EWGSOP2) definition has been used to guide the selection of the studies. The literature search identified 14 resistance exercise‐based studies and 5 nutrition plus RE interventional studies. Muscle strength outcomes were increased with longer intervention duration, intervention supervision, and high participant adherence. Data also suggested that CKD patients may require increased RE intensity and progressive loading to obtain detectable results in muscle mass. Unlike muscle strength and muscle mass, physical performance was readily improved by all types of exercise in long or short‐term interventions. Four studies used RE with high‐protein nutritional supplementation. These showed significant benefits on muscle strength and physical performance in dialysis patients while non‐significant results were found in muscle mass. More research is needed to confirm if a combination of RE and vitamin D supplementation could act synergistically to improve muscle strength in CKD. The current evidence on progressive RE for sarcopenia in CKD is encouraging; however, real‐life applications in clinical settings are still very limited. A multidisciplinary patient‐centred approach with regular follow‐up may be most beneficial due to the complexity of sarcopenia in CKD. Long‐term randomized control trials are needed to verify optimal RE prescription and explore safety and efficacy of other nutritional interventions in CKD.

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“…An open label clinical trial assessing the effect of the combination of two interventions (cholecalciferol supplementation and resistance training) on muscle strength and nutritional status in Stage 4 CKD was conducted by Olvera‐Soto et al 68 After the 12‐week intervention, there was an increase in handgrip strength on the intervention group. However, since this trial did not have a factorial design, it is not possible do determine whether the effect on muscle strength was due to exercise or supplementation intervention or due to a synergic effect between both interventions.…”

Section: Evidence In Patients With Chronic Kidney Disease or Kidney Failurementioning

confidence: 99%

Vitamin D and skeletal muscle: A narrative review focusing on chronic kidney disease and dialysis

Vogt

Caramori

2021

Hemodialysis International

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Morphological, molecular, and physiological effects of vitamin D on skeletal muscle have been analyzed both in animals and humans. Vitamin D may be a potential therapeutic for increasing muscle mass and function. The presence of vitamin D receptors in skeletal muscle cells is already established. However, there is still need for more evidence about the effect of vitamin D on muscle. Some studies have associated vitamin D and skeletal muscle in chronic kidney disease (CKD) patients; most of these studies enrolled hemodialysis patients. FGF‐23 and Klotho were recently described in mineral and bone disorders in CKD, resulting in reductions in calcitriol levels. Therefore, both Klotho and FGF‐23 may play a role in muscle loss in CKD, which is related to morbidity and mortality risk. Therefore, this article presents a narrative review, aiming to discuss the available information associating skeletal muscle and vitamin D, highlighting the results in CKD and dialysis patients.

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Effect of Resistance Exercise Plus Cholecalciferol on Nutritional Status Indicators in Adults With Stage 4 Chronic Kidney Disease

Cited by 4 publications

References 43 publications

Age, diabetes mellitus, and dialysis modality are associated with risk of poor muscle strength and physical function in hemodialysis and peritoneal dialysis patients

Age, diabetes mellitus, and dialysis modality are associated with risk of poor muscle strength and physical function in hemodialysis and peritoneal dialysis patients

Resistance exercise and nutritional interventions for augmenting sarcopenia outcomes in chronic kidney disease: a narrative review

Vitamin D and skeletal muscle: A narrative review focusing on chronic kidney disease and dialysis

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