Effect of an aerobic and strength exercise combined program on oxidative stress and inflammatory biomarkers in patients undergoing hemodialysis: a single blind randomized controlled trial

• Published in: International urology and nephrology Vol. 54; no. 9; pp. 2393 - 2405
• Main Authors: Meléndez-Oliva, Erika, Sánchez-Vera Gómez-Trelles, Isabel, Segura-Orti, Eva, Pérez-Domínguez, Borja, García-Maset, Rafael, García-Testal, Alicia, Lavandera-Díaz, Jose Luis
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-09-2022; Springer Nature B.V
• Subjects: Biomarkers; Exercise; Hemodialysis; Inflammation; Intercellular adhesion molecule 1; Interleukin 6; Kidney diseases; Medicine; Medicine & Public Health; Monocyte chemoattractant protein 1; Nephrology; Nephrology - Original Paper; Oxidative stress; Patients; Physical fitness; Physical training; Plasma levels; Serum levels; Tumor necrosis factor-α; Urology; Chronic renal disease; Oxidative stress; Inflammation; Exercise; Hemodialysis
• ISSN: 1573-2584; 0301-1623; 1573-2584
• DOI: 10.1007/s11255-022-03146-z

Background
Chronic kidney disease patients on hemodialysis treatment are characterized by increased levels of inflammatory markers and oxidative stress, in addition to a significant deterioration in physical function. The benefits of physical exercise on the functional capacity of this patients are well known; however, it can also improve the endogenous antioxidant defense system and the inflammatory state, but still very few studies have been carried out. This is the first study to analyze the effect of a 4-month exercise program with combined aerobic and strength training in patients undergoing hemodialysis, under two modalities.
Methods
Seventy-one patients undergoing hemodialysis were enrolled and randomized in two groups, one of them performing an intra-dialysis exercise program (
n = 
36), and the other carrying out a home-based exercise program (
n = 
35). Serum levels of oxidative stress and inflammation biomarkers were determined before and after the intervention.
Results
IL-6 plasma levels showed a significant decrease in the intra-dialysis group after exercise (42.61 ± 9.21 to 26.40 ± 7.84,
p = 
0.03), while CRP levels decreased significantly in the home-based group (16.12 ± 24.18 to 8.50 ± 11.28,
p = 
0.03). MCP-1, TNF-α, ICAM-1 and the oxidative stress markers MDA, GSH and GSSG, did not undergo significant changes after the intervention.
Conclusion
Four months of combined strength and aerobic endurance exercise improve the inflammatory status of hemodialysis patients by significantly reducing IL-6 levels in those subjects who perform intra-dialysis exercise and CRP levels in those who do it at home.