Effect of acute intradialytic strength physical exercise on oxidative stress and inflammatory responses in hemodialysis patients.
BACKGROUND
Oxidative stress and inflammation are common findings in chronic kidney disease (CKD) patients, and they are directly related to the increased risk of developing cardiovascular disease, which is the major cause of death in these patients, particularly for those undergoing hemodialysis (HD). Strength physical exercise is a new therapeutic approach to reduce these complications in CKD patients. Following this, the purpose of this study was to assess the effect of acute intradialytic strength physical exercise on oxidative stress and inflammatory responses in HD patients.


METHODS
Sixteen HD patients were studied (11 women; 44.4±14.6 years; body mass index 23.3±4.9 kg/m(2); 61.6±43.1 months of dialysis) and served as their own controls. Acute (single session) intradialytic physical exercise were performed at 60% of the one-repetition maximum test for three sets of 10 repetitions for four exercise categories in both lower limbs during 30 minutes. Blood samples were collected on two different days at exactly the same time (30 minutes and 60 minutes after initiating the dialysis-with and without exercise). Antioxidant enzymes activity [superoxide dismutase (SOD), catalase, and glutathione peroxidase], lipid peroxidation marker levels (malondialdehyde), and inflammatory marker levels (high-sensitivity C-reactive protein) were determined.


RESULTS
SOD plasma levels were significantly reduced after acute physical exercise from 244.8±40.7 U/mL to 222.4±28.9 U/mL (P=0.03) and, by contrast, increased on the day without exercise (218.2±26.5 U/mL to 239.4±38.6 U/mL, P=0.02). There was no alteration in plasma catalase, glutathione peroxidase, malondialdehyde, or high-sensitivity C-reactive protein levels in on either day (with or without exercise). Additionally, there was no association between these markers and clinical, anthropometric, or biochemical parameters.


CONCLUSIONS
These data suggest that acute intradialytic strength physical exercise was unable to reduce oxidative stress and inflammation, and in addition, it seems to reduce plasma SOD levels, which could exacerbate the oxidative stress in HD patients.
University of Medicine of Lisbon, Post-Graduation in Clinical Nutrition, Lisbon, Portugal ; Fluminense Federal University, Post-Graduation in Cardiovascular Sciences, Niterói-RJ, Brazil.
Marta
M
Esgalhado
Fluminense Federal University, Post-Graduation in Cardiovascular Sciences, Niterói-RJ, Brazil.
Milena Barcza
MB
Stockler-Pinto
Fluminense Federal University, Post-Graduation in Cardiovascular Sciences, Niterói-RJ, Brazil.
Ludmila Ferreira Medeiros
LF
de França Cardozo
Fluminense Federal University, Post-Graduation in Cardiovascular Sciences, Niterói-RJ, Brazil.
Cinthia
C
Costa
Fluminense Federal University, Post-Graduation in Medical Sciences, Niterói-RJ, Brazil.
Jorge Eduardo
JE
Barboza
Fluminense Federal University, Post-Graduation in Cardiovascular Sciences, Niterói-RJ, Brazil ; Fluminense Federal University, Post-Graduation in Medical Sciences, Niterói-RJ, Brazil.
Denise
D
Mafra
Acute physical exercise; Chronic kidney disease; Hemodialysis; Inflammatory and oxidative stress markers