title: Resistance exercise: a strategy to attenuate inflammation and protein-energy wasting in hemodialysis patients?
abstract: OBJECTIVE
  Patients undergoing hemodialysis (HD) present persistent inflammation and protein-energy wasting (PEW), which contributes to high rates of mortality. This study aimed to assess the effects of a resistance exercise training program (RETP) on inflammation and PEW in HD patients.
  
  
  METHODS
  Thirty-seven patients (56.7 % men, 45.9 ± 14.1 years, 23.5 ± 3.9 kg/m(2)) performed 6 months of intradialytic RETP. Plasma adhesion molecules levels (ICAM-1 and VCAM-1) were measured using the enzyme immunometric assay, and interleukin-6 (IL-6), C-reactive protein, and tumor necrosis factor-alpha by ELISA. Anthropometric, physical capacity, and PEW (simultaneously presence of: BMI <23 kg/m(2), serum albumin <3.8 g/dL, and reduced arm muscle area) were analyzed.
  
  
  RESULTS
  There was a reduction of ICAM-1 [(1,934.1 pg/mL (1,031.8-2,875.0) vs. 1,571.1 pg/mL (447.1-2,985.5), p < 0.05], VCAM-1 [5,259.51 pg/mL (3,967.4-6,682.4) vs. 3,062.11 pg/mL (2,034.0-5,034.4), p < 0.05], and CRP levels (2.3 ± 0.9 to 1.6 ± 0.6 pg/mL, p < 0.001) after 6 months of RETP. Body composition improved, albumin increased (3.7 ± 0.3 to 3.9 ± 0.2, p < 0.05), and the number of patients presenting PEW was decreased (p = 0.005).
  
  
  CONCLUSIONS
  Resistance exercise program for 6 months seems to be effective in reducing inflammation and PEW of HD patients. The universal trial number of this study is U1111-1139-1326.
authors.affiliation: Graduate Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil, moraesmjc@gmail.com.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Moraes
authors.forename: Sandra Mara
authors.initials: SM
authors.lastname: Marinho
authors.forename: Antonio Claudio
authors.initials: AC
authors.lastname: da Nobrega
authors.forename: Bruno
authors.initials: B
authors.lastname: de Oliveira Bessa
authors.forename: Ludmilla Viana
authors.initials: LV
authors.lastname: Jacobson
authors.forename: Milena Barcza
authors.initials: MB
authors.lastname: Stockler-Pinto
authors.forename: Wellington Seguins
authors.initials: WS
authors.lastname: da Silva
authors.forename: Denise
authors.initials: D
authors.lastname: Mafra
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology / Q000628:therapy*; D015850:Interleukin-6 / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy; D055070:Resistance Training; D012709:Serum Albumin / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D012709:Serum Albumin; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
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