Exercise Training Alters the Bone Mineral Density of Hemodialysis Patients

Abstract

Marinho, SM, Moraes, C, Barbosa, JEdSM, Eduardo, JCC, Fouqe, D, Pelletier, S, and Mafra, D. Exercise training alters the bone mineral density of hemodialysis patients. J Strength Cond Res 30(10): 2918-2923, 2016-Patients with chronic kidney disease undergoing hemodialysis (HD) frequently present low bone mineral density (BMD), and exercise may be useful for treating bone loss. This study aimed to assess the effects of an intradialytic resistance exercise training program (RETP) on BMD in HD patients. Twenty-one patients were enrolled into 2 groups; 10 patients performed exercise (80.0% men; 46.9 ± 12.1 years; 27.0 ± 3.4 kg·m) and 11 patients were in the control group (54.5% men; 50.5 ± 11.5 years; 24.1 ± 8.7 kg·m). Dual-energy x-ray absorptiometry was used to measure the BMD, lean mass, and body fat before and after the supervised RETP (performed with elastic bands and ankle cuffs in both lower limbs 3 times a week for 24 weeks-72 sessions). In the exercise group, 30.0% of patients presented with osteopenia and 20.0% osteoporosis and in the control group, 45.5% osteopenia and 36.4% osteoporosis. Only in the exercise group, the osteoporosis percentage was reduced to 10.0% and the femoral neck BMD and T-score improved from 0.89 ± 0.1 to 0.93 ± 0.1 g·cm and from -1.3 ± 0.8 to -1.0 ± 0.8 g·cm (p ≤ 0.05), respectively, after the intervention. In contrast, these parameters were reduced in the control group. The results suggest that resistance exercise may be useful for improving the BMD in HD patients. In summary, 24 weeks of the supervised RETP played a role in improving the BMD of HD patients.

Intradialytic Cognitive and Exercise Training May Preserve Cognitive Function

“…There is a general consensus that intradialytic ET is safe, 57 , 58 and our study supported the safety of intradialytic ET and intradialytic CT. As might be expected, previous studies demonstrated an impact of intradialytic ET (i.e., physical exercise) on physical findings, including physical function, 45 , 46 , 50 treatment-related symptoms, 59 dialysis efficacy, 60 inflammation, 45 bone mineral density, 45 , 47 quality of life, 48 peak oxygen consumption, 49 , 50 anxiety, 51 and exercise capacity. 61 We extended these studies to test the impact of physical exercise on cognitive findings (i.e., intradialytic ET preserves cognitive function).…”

“…Exclusion criteria included angina pectoris, chronic lung disease, cerebral vascular disease, musculoskeletal or orthopedic conditions limiting physical activity, lower or upper extremity amputation, decreased mental capacity, or diagnosed dementia, consistent with previous exercise intervention studies of HD patients. 45 , 46 , 47 , 48 , 49 , 50 , 51 We approached 27 HD patients, and 1 was not eligible. Of the 26 patients identified as eligible, 23 agreed to participate, and 20 were available for follow-up at 3 months (the other 3 changed dialysis centers during the study and were excluded) ( Figure 1 ).…”

The Effect of Intradialytic Isometric Resistance Training on Muscle capacity and Serum Albumin Levels in Hemodialysis Patients

“…Although RT has been applied in HD patients across different studies, there is no consensus concerning its use in these patients (8,11). Chronic kidney disease patients, undergoing hemodialysis frequently, present low bone mineral density (BMD); a study showed that resistance exercise could improve the BMD of HD patients (12). Another study found that the acute effect of resistance exercise in HD patients could increase the acyl-gherlin (the hunger hormone) and decrease obestatin (the hormone that leads to feeling full) levels, which means it could be beneficial for increasing the appetite of these patients, which was another problem for them (13).…”

Entrenamiento físico en personas con enfermedad renal crónica avanzada: beneficios de su implementación en la práctica clínica

“…Otro beneficio del ejercicio, en particular el de resistencia, es su utilidad para mejorar la densidad mineral ósea en pacientes en HDC, describiéndose en un estudio experimental una reducción significativa del porcentaje de osteoporosis en el grupo que realizó ejercicio 36 . También se han comunicado beneficios de programas de ejercicio intradiálisis adaptados para pacientes ancianos con alta comorbilidad en HDC (mayores a 75 años), observando mejoras significativas en la fuerza muscular, capacidad funcional, sintomatología depresiva y calidad de vida relacionada a salud (CVRS) 37 .…”