Impact of Low Hemoglobin on Body Composition, Strength, and Redox Status of Older Hemodialysis Patients Following Resistance Training

Abstract

IntroductionThe purpose of this study was to: (i) investigate the effect of six months of resistance training (RT) on body composition, muscle strength, hematological patterns, and redox profile in maintenance hemodialysis (HD) patients, and; (ii) evaluate the effects of baseline concentrations of hemoglobin on the RT response.MethodsOne hundred fifty-seven subjects with chronic kidney disease (CKD) were randomly allocated into two groups: Control [CTL, (n = 76)] and RT (n = 81). A first visit was required for anamnesis and anthropometric measurements. Venous blood samples were collected at baseline and after twenty-four weeks of training in all patients for the analysis of clinical and redox balance markers. The RT program spanned six months and consisted of three sets of 8–12 repetitions with a rating of perceived exertion between 5 and 8 for three weekly sessions. Each exercise session was performed in twelve resistance exercises and it least for approximately 40 min.ResultsThe main results demonstrated that RT decreased waist circumference by 3%, and decreased thiobarbituric reactive species (TBARS) by 28%. Moreover, RT increased handgrip strength by 28.4%, fat-free mass by 4.1%, hemoglobin by 5%, iron by 33.4%, glutathione by 121%, and Trolox equivalent antioxidant capacity by 14.2% (p < 0.05). Low hemoglobin concentrations impaired the effect of RT on fat-free mass gain.ConclusionSix months of RT in HD patients improved clinical parameters, such as hemoglobin, iron, body composition, and redox balance, while low hemoglobin concentration impaired exercise-benefits on fat-free mass in patients with CKD. These findings can contribute to a better clinical application of RT in the maintenance of hemodialysis patients.

Effect of exercise and antioxidant supplementation on cellular lipid peroxidation in elderly individuals: Systematic review and network meta-analysis

“…Among the 49 studies, 2 studies were excluded due to their ineligible interventions, 1 study was excluded because of its ineligible language, and 27 studies were excluded because of their ineligible comparators. Eventually, 7 studies were included in the systematic review ( Alghadir et al, 2016 ; Campbell et al, 2010 ; da Silva et al, 2021 ; Dani et al, 2020 ; Fatouros et al, 2004 ; Osali, 2020 ; Vincent et al, 2002 ). The flow diagram was presented in Figure 1 .…”

Synergistic deterioration of prognosis associated with decreased grip strength and hyporesponse to erythropoiesis-stimulating agents in patients undergoing hemodialysis

“…Several studies have reported the effects of exercise therapy on anemia as well as the relationship between anemia and muscle weakness [ 26–28 ]. Treatment of anemia is an important factor in improving frailty in healthy people [ 13 ], and resistance training for muscle strength was reported to improve HGS and Hb levels in patients undergoing HD [ 28 ].…”

“…The guidelines for renal rehabilitation, published by the Japanese Society of Renal Rehabilitation in 2018 note that exercise therapy is reported to be effective for improving exercise tolerance, QoL, dialysis efficiency, and ADL, preventing and improving protein-energy wasting, inhibiting protein catabolism, and preventing cardiovascular disease [ 15 ]. To avoid the risk of CVD in patients receiving high-dose ESA treatment [ 25 ], improvement of anemia by exercise treatment [ 26 , 28 ] might be useful.…”

Does the Combined Effect of Resistance Training with EPO and Iron Sulfate Improve Iron Metabolism in Older Individuals with End-Stage Renal Disease?

“…Because of that, ESA and iron supplementation may be considered to improve health-related parameters in this population [ 1 , 2 ]. RT has appeared as a non-pharmacological therapy to improve iron metabolism in this population [ 6 , 8 , 17 ]. The possibility of using RT as part of the treatment of iron deficiency may lead to relevant management of anemia biomarkers ( Figure 2 and Figure 3 ).…”

“…In our study, 72.61% of the patients underwent EPO treatment (control group (CTL) = 69.73%; resistance training group (RT) = 75.30%) and 54.14% underwent oral iron supplementation (CTL = 55.26%; RT = 53.08%). Given that both treatments may influence multifactorial pathways related to inflammation and iron status, and RT is an important regulator of both aforementioned factors [ 6 , 7 , 8 , 9 ], two fundamental questions are raised here: (I) Does RT enhance the treatment with EPO and iron sulfate in ESRD older individuals? (II) Is RT an effective treatment on its own to improve iron status?…”