Improving the prognosis of renal patients: The effects of blood flow‐restricted resistance training on redox balance and cardiac autonomic function

Abstract

Patients with chronic kidney disease (CKD) are prone to cardiovascular diseases secondary to abnormalities in both autonomic cardiac function and redox balance [myeloperoxidase (MPO) to paraoxonase 1 (PON1) ratio]. Although aerobic training improves both autonomic balance and redox balance in patients with CKD, the cardioprotective effects of resistance training (RT), with and without blood flow restriction (BFR), remain unknown. We aimed to compare the effects of RT and RT+BFR on antioxidant defence (PON1), pro-oxidative status (MPO), cardiac autonomic function (quantified by heart rate variability analysis) and renal function. Conservative CKD (stages 1 to 5 who do not need hemodialysis) patients (n = 105, 33 female) of both sexes were randomized into three groups: control (CTL; 57.6 ± 5.2 years; body mass index, 33.23 ± 1.62 kg/m 2), RT (58.09 ± 6.26 years; body mass index 33.63 ± 2.05 kg/m 2) and RT+BFR (58.06 ± 6.47 years; body mass index, 33.32 ± 1.87 kg/m 2). Patients completed 6 months of RT or RT+BFR on three non-consecutive days per week under the supervision of strength and conditioning professionals. Training loads were adjusted every 2 months. Heart rate variability was recorded with a Polar-RS800 and data were analysed for time and frequency domains using Kubios software. The redox balance markers were PON1 and MPO, which were analysed in plasma samples. Renal function was estimated as estimated glomerular filtration rate. The RT and RT+BFR decreased pro-oxidative MPO (RT, ∼34 ng/ml and RT+BFR, ∼27 ng/ml),

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

“…From a biochemical perspective, a persistent state of oxidative stress leads to low BDNF levels, increasing the vulnerability to depression symptoms, which could be treated by improving antioxidant defenses [ 31 ]. Evidence shows that RT has a great potential to enhance antioxidant defenses [ 13 , 32 , 33 ] and increase BDNF levels [ 16 ]. Currently, a study proposed the interplay between muscle and brain BDNF-mediated redox regulation.…”

“…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.…”

A Useful Blood Flow Restriction Training Risk Stratification for Exercise and Rehabilitation

“…BFRT may become a potentially valuable tool for chronic kidney disease (CKD) patients as they present low tolerance to heightened perceptual demands of exercise training ( Correa et al, 2021a , b ; de Deus et al, 2021 ; Deus et al, 2022 ). Randomized controlled trials using the same protocol compared the effects of 6 months of periodized resistance training with and without BFRT 3 days a week in male and female patients with stage 2 CKD with hypertension and DM.…”

“…BFRT may become a potentially valuable tool for chronic kidney disease (CKD) patients as they present low tolerance to heightened perceptual demands of exercise training (Correa et al, 2021a,b;de Deus et al, 2021;Deus et al, 2022). Randomized controlled trials using the same protocol compared the effects of 6 months of periodized resistance training with and without BFRT 3 days a week in male and female Fall in systolic blood pressure below resting levels during exercise; Non-sustained ventricular tachycardia with exercise; Previous episode of primary cardiac arrest (e.g., cardiac arrest that did not occur in the presence of an acute myocardial infarction or during a cardiac procedure); SBP ≥ 160 mmHg and/or DBP ≥ 100 mmHg prior to exercise; Uncontrolled hypertension (>180/110 mmHg); SBP between 160 and 179 mmHg or DBP between 100 and 109 mmHg with the presence of 1 cardiovascular risk factor a , with target organ damage b , chronic kidney disease or diabetes mellitus;…”