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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

  • Nephrology - Original Paper
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Abstract

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.

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Acknowledgements

The authors would like to thank Ms. Susana Arahuetes Ruiz for her help.

Funding

This work has been financed by “Ayudas a Proyectos En Consolidación CEU—Banco Santander” (USPBS-PCON04-2015) Universidad CEU San Pablo. Madrid, Spain.

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Authors and Affiliations

  1. Department of Biomedical Sciences, Universidad CEU Cardenal Herrera, CEU Universities, Elche, Spain

    Erika Meléndez-Oliva

  2. Department of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain

    Eva Segura-Orti & Borja Pérez-Domínguez

  3. Department of Basic Medical Sciences. Medical School, Universidad CEU San Pablo, CEU Universities, Madrid, Spain

    Isabel Sánchez-Vera Gómez-Trelles & Jose Luis Lavandera-Díaz

  4. Nephrology Department, Hospital de Manises, Valencia, Spain

    Rafael García-Maset & Alicia García-Testal

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  1. Erika Meléndez-Oliva
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Contributions

RGM, ESO and JLL: conceived the project; AGT and RGM: performed patient enrollment, clinical review and monitoring; EMO and BPD: implemented and performed exercise program monitoring; IS-V and JLL: designed the biochemical experiments; EMO, IS-V and JLL: performed the biochemical experiments. AGT., RGM., IS-V, ESO and JLL: analyzed and interpreted data. IS-V, ESO: reviewed the article. EMO and JLL wrote the article. The authors declare that all data were generated in-house and that no paper mill was used.

Corresponding authors

Correspondence to Erika Meléndez-Oliva or Jose Luis Lavandera-Díaz.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

The research proposal received approval from the Ethics Committee of Biomedical Research of University and Polytechnic Hospital La Fe of Valencia (register number 2016/0123) and all patients gave written informed consent to participate.

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Meléndez-Oliva, E., Sánchez-Vera Gómez-Trelles, I., Segura-Orti, E. et al. 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. Int Urol Nephrol 54, 2393–2405 (2022). https://doi.org/10.1007/s11255-022-03146-z

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