Effects of intradialytic exercise on systemic cytokine in patients with chronic kidney disease.
BACKGROUND
Immunological dysfunctions and a pro-inflammatory environment are associated with higher risk of cardiovascular diseases in chronic kidney disease (CKD). Physical exercise can be an important anti-inflammatory strategy, but the effects in CKD remain poorly investigated.


OBJECTIVE
Evaluate the acute inflammatory response to intradialytic exercise in the peripheral blood of individuals with CKD.


METHODS
Nine patients, of both genders, with CKD and allocated in the ambulatory of hemodialysis of Hospital Ernesto Dornelles (Brazil), performed two sessions of hemodialysis (HD) in random form: aerobic intradialytic exercise sessions (EX, 20 min of moderate exercise in cycle-ergometer) and a control hemodialysis session (CON). Peripheral blood collection was made at the baseline, during and immediately after HD to evaluate the cytokine profile: interleukin-6, interleukin-10 (IL-10), interleukin-17a (IL-17a), interferon-gamma (INF-γ) and tumoral necrosis factor-alpha (TNF-α).


RESULTS
INF-γ decreased during HD when compared with the pre moment in both sessions, while an increase in post HD was only found in the CON session. IL-17 was higher in post when compared with during HD in both sessions. In addition to the time effect, IL-10 presented a time × group interaction and the relative changes were significantly higher in EX when compared with the CON session. The relative changes in TNF-α tended to be higher in CON when compared with EX immediately post HD session.


CONCLUSIONS
These data indicate that 20 min of intradialytic exercise have modest effect in systemic inflammation. However, the significant increase in IL-10 may indicate an immunoregulatory effect of physical exercise.
Research Center, Centro Universitário Metodista IPA , Porto Alegre , Brazil .
Alessandra
A
Peres
Daniela Lazzarotto
DL
Perotto
Gilson Pires
GP
Dorneles
Maria Isabel Severini
MI
Fuhro
Mariane Borba
MB
Monteiro
Chronic kidney disease; hemodialysis; inflammation; peripheral blood; physical exercise