The effects of aerobic exercise on biochemical parameters in individuals with CKD on hemodialysis: A longitudinal study

  • Fabiano Santana de Oliveira Universidade Federal do Acre (UFAC) – Rio Branco (AC), Brasil/ Programa de Pós-Graduação em Ciências da Saúde, Centro Universitário Saúde ABC, Santo André (SP), Brasil/ Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário Saúde ABC, Santo André (SP), Brasil
  • Mauro José de Deus Morais Universidade Federal do Acre (UFAC) – Rio Branco (AC), Brasil/ Programa de Pós-Graduação em Ciências da Saúde, Centro Universitário Saúde ABC, Santo André (SP), Brasil/ Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário Saúde ABC, Santo André (SP), Brasil
  • Luiz Carlos de Abreu Programa de Pós-Graduação em Ciências da Saúde, Centro Universitário Saúde ABC, Santo André (SP), Brasil/ Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário Saúde ABC, Santo André (SP), Brasil
  • Andrés Ricardo Pérez-Riera Programa de Pós-Graduação em Ciências da Saúde, Centro Universitário Saúde ABC, Santo André (SP), Brasil/ Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário Saúde ABC, Santo André (SP), Brasil
  • Vitor E. Valenti Centro de Estudos do Sistema Nervoso Autônomo (CESNA), Departamento de Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista (UNESP) – Marília (SP), Brasil
  • Laércio da Silva Paiva Departamento de Saúde da Coletividade, Laboratório de Epidemiologia e Análise de Dados, Centro Universitário Saúde ABC, Santo André (SP), Brasil
  • Rodrigo Daminello Raimundo Programa de Pós-Graduação em Ciências da Saúde, Centro Universitário Saúde ABC, Santo André (SP), Brasil/ Laboratório de Delineamento de Estudos e Escrita Científica, Centro Universitário Saúde ABC, Santo André (SP), Brasil
Keywords: Chronic kidney disease, Hemodialysis, Blood parameters, Aerobic exercises

Abstract

Background: Chronic kidney disease is directly related to cardiovascular disorders. Guided physical exercises significantly improve the adverse effects of dialytic treatment.

Objective: To analyze changes in biochemical parameters of subjects with chronic kidney disease undergoing moderate exercise during hemodialysis.

Methods: This is an experimental study composed of 54 subjects submitted to hemodialysis, split into a control group and a group with intervention. The experimental group underwent three weekly sessions of aerobic exercise, performed during hemodialysis sessions, with a duration of 30 minutes, for 12 weeks. The blood parameters of both groups were compared.

Results: Statistically significant differences were observed between pre (p=0.001) and post-exercise protocol for urea (p=0.006), calcium (p=0.001), alanine aminotransferase (p=0.020) and sodium (p=<0.001). In the control group, we observed significant differences for the calcium variable (p<0.001), alanine aminotransferase (p=0.024), hematocrit (p=0.015), calcium vs phosphorus (p=0.018), and sodium (p=0.023), before and after the period.

Conclusion: Aerobic training during hemodialysis was able to maintain blood level stability in patients with chronic kidney disease, both during and at the end of the protocol, even considering increased blood flow. This trial is registered in the Brazilian registry of clinical Trials - number RBR-7354r6. Registration date: July 5, 2018 at 12:59 PM. Last Update: July 24, 2018 at 10:24 AM. Identification of the test - UTN Number: U1111-1216-8272.

Downloads

Download data is not yet available.

References

1. Heiwe S, Clyne N, Dahlgren MA. Living with chronic renal failure: patients' experiences of their physical and functional capacity. Physiother Res Int . 2003;8(4):167-77. DOI: http://doi.org/10.1002/pri.287

2. Locatelli F, Del Vecchio L, Pozzoni P. The importance of early detection of chronic kidney disease. Nephrol Dial Transplant. 2002;17(suppl 11):2-7. DOI: http://doi.org/10.1093/ndt/17.suppl_11.2

3. Moinuddin I, Leehey DJ. A comparison of aerobic exercise and resistance training in patients with and without chronic kidney disease. Adv Chronic Kidney Dis. 2008;15(1):83-96. DOI: http://doi.org/10.1053/j.ackd.2007.10.004

4. Sietsema KE, Amato A, Adler SG, Brass EP. Exercise capacity as a predictor of survival among ambulatory patients with end-stage renal disease. Kidney Int. 2004;65(2):719-24. DOI: http://doi.org/10.1111/j.1523-1755.2004.00411.x

5. Knight EL, Ofsthun N, Teng M, Lazarus JM, Curhan GC. The association between mental health, physical function, and hemodialysis mortality. Kidney Int. 2003;63(5):1843-51. DOI: http://doi.org/10.1046/j.1523-1755.2003.00931.x

6. Heiwe S, Jacobson SH. Exercise Training in Adults With CKD: A Systematic Review and Meta-analysis. Am J Kidney Dis. 2014;64(3):383-93. DOI: http://doi.org/10.1053/j.ajkd.2014.03.020

7. Aoike DT, Baria F, Kamimura MA, Ammirati A, Mello MT, Cuppari L. Impact of home-based aerobic exercise on the physical capacity of overweight patients with chronic kidney disease. Int Urol Nephrol. 2015;47(2):359-67. DOI: http://doi.org/10.1007/s11255-014-0894-8

8. Heiwe S, Jacobson SH. Exercise training for adults with chronic kidney disease. Cochrane Database Syst Rev. 2011;10(10):CD003236. DOI: http://doi.org/10.1002/14651858.CD003236.pub2

9. Ploeger HE, Takken T, Greef MHG, Timmons BW. The effects of acute and chronic exercise on inflammatory markers in children and adults with a chronic inflammatory disease: a systematic review. Exerc Immunol Rev. 2009;15(1):6-41

10. Powers SK, Jackson MJ. Exercise-induced oxidative stress: cellular mechanisms and impact on muscle force production. Physiol Rev. 2008;88(4):1243-76. DOI: http://doi.org/10.1152/physrev.00031.2007

11. Roxo RS, Xavier VB, Miorin LA, Magalhaes AO, Sens YA, Alves VL. Impact of neuromuscular electrical stimulation on functional capacity of patients with chronic kidney disease on hemodialysis. J Bras Nefrol. 2016;38(3):344-50. DOI: http://dx.doi.org/10.5935/0101-2800.20160052

12. Vargas-Mendoza N, Morales-Gonzalez A, Madrigal-Santillan EO, Madrigal-Bujaidar E, Alvarez-Gonzalez I, Garcia-Melo LF, et al. Antioxidant and Adaptative Response Mediated by Nrf2 during Physical Exercise. Antioxidants (Basel). 2019;8(6):196. DOI: http://dx.doi.org/10.3390/antiox8060196

13. Cartee GD, Hepple RT, Bamman MM, Zierath JR. Exercise Promotes Healthy Aging of Skeletal Muscle. Cell Metab. 2016;23(6):1034-47. DOI: http://dx.doi.org/10.1016/j.cmet.2016.05.007

14. Viana JL, Kosmadakis GC, Watson EL, Bevington A, Feehally J, Bishop NC, et al. Evidence for anti-inflammatory effects of exercise in CKD. J Am Soc Nephrol. 2014;25(9):2121-30. DOI: http://dx.doi.org/10.1681/ASN.2013070702

15. Sethna CB, Salerno AE, McBride MG, Shults J, Paridon SM, Sharma N, et al. Cardiorespiratory fitness in pediatric renal transplant recipients. Transplantation. 2009;88(3):395. DOI: http://dx.doi.org/10.1097/TP.0b013e3181aed7d1

16. Parsons TL, Toffelmire EB, King-VanVlack CE. The effect of an exercise program during hemodialysis on dialysis efficacy, blood pressure and quality of life in end-stage renal disease (ESRD) patients. Clin Nephrol. 2004;61(4):261-74. DOI: http://doi.org/10.5414/cnp61261

17. Abreu LC, Pereira VX, Silva RPM, Macedo Jr H, Bezerra IMP. The right to scientific information: one of the main elements of the unified health system. J Hum Growth Dev. 2017;27(3):258-61. DOI: http://dx.doi.org/10.7322/jhgd.141485

18. Bezerra IMP. Translational medicine and its contribution to public health. J Hum Growth Dev. 2017;27(1):6-9. DOI: http://dx.doi.org/10.7322/jhgd.127642

19. Moraes SDTA. Scientific method and research in health: orientation for professional practice. J Hum Growth Dev. 2019;29(1):5-9. DOI: http://dx.doi.org/10.7322/jhgd.157742

20. Morais MJD, Raimundo RD, Oliveira FS, Abreu LC, Bezerra IMP, Silva RPM, et al. Evaluation of the effects of aerobic training during hemodialysis on autonomic heart rate modulation in patients with chronic renal disease. Medicine (Baltimore). 2019;98(23):e15976. DOI: http://doi.org/10.1097/MD.0000000000015976

21. Morais MJD, Abreu LC, Oliveira FS, Bezerra IMP, Raimundo RD, Silva RPM, et al. Is aerobic exercise training during hemodialysis a reliable intervention for autonomic dysfunction in individuals with chronic kidney disease? A prospective longitudinal clinical trial. J Multidiscip Healthc. 2019;12:711-8. DOI: http://doi.org/10.2147/JMDH.S202889

22. Vecchi AF, Colucci P, Salerno F, Scalamogna A, Ponticelli C. Outcome of peritoneal dialysis in cirrhotic patients with chronic renal failure. Am J Kidney Dis. 2002;40(1):161-8. DOI: http://doi.org/10.1053/ajkd.2002.33925

23. Qiu Z, Zheng K, Zhang H, Feng J, Wang L, Zhou H. Physical Exercise and Patients with Chronic Renal Failure: A Meta-Analysis. Biomed Res Int. 2017;2017:7191826. DOI: http://doi.org/10.1155/2017/7191826

24. Fuhro MI, Dorneles GP, Andrade FP, Romao PRT, Peres A, Monteiro MB. Acute exercise during hemodialysis prevents the decrease in natural killer cells in patients with chronic kidney disease: a pilot study. Int Urol Nephrol. 2018;50(3):527-34. DOI: DOI: http://doi.org/10.1007/s11255-017-1747-z

25. Musavian AS, Soleimani A, Masoudi Alavi N, Baseri A, Savari F. Comparing the effects of active and passive intradialytic pedaling exercises on dialysis efficacy, electrolytes, hemoglobin, hematocrit, blood pressure and health-related quality of life. Nurs Midwifery Stud. 2015;4(1):e25922. DOI: http://doi.org/10.17795/nmsjournal25922

26. Mohseni R, Emami Zeydi A, Ilali E, Adib-Hajbaghery M, Makhlough A. The effect of intradialytic aerobic exercise on dialysis efficacy in hemodialysis patients: a randomized controlled trial. Oman Med J. 2013;28(5):345-9. DOI: http://doi.org/10.5001/omj.2013.99

27. Vaithilingam I, Polkinghorne KR, Atkins RC, Kerr PG. Time and exercise improve phosphate removal in hemodialysis patients. Am J Kidney Dis. 2004;43(1):85-9. DOI: http://doi.org/10.1053/j.ajkd.2003.09.016

28. Dinkova-Kostova AT, Abramov AY. The emerging role of Nrf2 in mitochondrial function. Free Radic Biol Med. 2015;88(Pt B):179-88. DOI: http://doi.org/10.1016/j.freeradbiomed.2015.04.036

29. Scarpulla RC. Nuclear control of respiratory chain expression by nuclear respiratory factors and PGC-1-related coactivator. Ann N Y Acad Sci. 2008;1147:321-34. DOI: http://doi.org/10.1196/annals.1427.006

30. Sette LHBC, Lopes EPA. Liver enzymes serum levels in patients with chronic kidney disease on hemodialysis: a comprehensive review. Clinics (Sao Paulo, Brazil). 2014;69(4):271-8. DOI: http://doi.org/10.6061/clinics/2014(04)09

31. Small DM, Beetham KS, Howden EJ, Briskey DR, Johnson DW, Isbel NM, et al. Effects of exercise and lifestyle intervention on oxidative stress in chronic kidney disease. Redox Rep. 2017;22(3):127-36. DOI: http://doi.org/10.1080/13510002.2016.1276314

32. Santana DA, Poortmans JR, Dorea EL, Machado JBA, Fernandes AL, Sá-Pinto AL, et al. Acute exercise does not impair renal function in nondialysis chronic kidney disease patients regardless of disease stage. Am J Physiol Renal Physiol. 2017;313(2):F547-52. DOI: http://doi.org/10.1152/ajprenal.00131.2017

33. Block GA, Hulbert-Shearon TE, Levin NW, Port FK. Association of serum phosphorus and calcium x phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am J Kidney Dis. 1998;31(4):607-17. DOI: http://doi.org/10.1053/ajkd.1998.v31.pm9531176
Published
2020-06-17
Section
ORIGINAL ARTICLES