The Effect of Resistance Exercise to Augment Long-term Benefits of Intradialytic Oral Nutritional Supplementation in Chronic Hemodialysis Patients
published online 28 June 2010. Corrected Proof
Background
Resistance exercise combined with intradialytic oral nutrition (IDON) supplementation improves net protein balance in the acute setting in chronic hemodialysis patients. We hypothesized that combination of long-term resistance exercise and IDON would improve markers of muscle mass and strength further compared with IDON alone.
Methods
Thirty-two participants (21 male; mean age, 43 ± 13 years) on chronic hemodialysis were randomly assigned to IDON plus resistance exercise (NS + EX), or IDON (NS) alone for 6 months. IDON consisted of a lactose-free formula consisting of protein, carbohydrate, and fat. Three sets of 12 repetitions of leg-press were completed before each dialysis session in the NS + EX arm. Primary outcome measurement was lean body mass. Muscle strength and other nutritional parameters were measured as secondary outcomes.
Results
Of 32 participants, 22 completed the 6-month intervention. There were no statistically significant differences between the study interventions with respect to changes in lean body mass and body weight, when comparing NS + EX to NS. There were also no statistically significant differences in any of the secondary outcomes measured in the study. Body weight (80.3 ± 16.6 kg, 81.1 ± 17.5 kg, and 80.9 ± 18.2 kg at baseline, month 3, and month 6, respectively; P = .02) and 1-repetition maximum (468 ± 148 lb, 535 ± 144 lb, and 552 ± 142 lb, respectively; P = .001) increased statistically significantly during the study for all patients combined.
Conclusion
This study did not show further benefits of additional resistance exercise on long-term somatic protein accretion above and beyond nutritional supplementation alone. When both treatments groups were combined, body weight and muscle strength improved during the study.
∗Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
†Division of Nephrology, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China
‡Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
Address reprint requests to T. Alp Ikizler, MD, Division of Nephrology, Vanderbilt University Medical Center, 1161 21st Ave. South & Garland, S-3223 MCN, Nashville, TN 37232-2372.
This study was supported in part by R01 DK45604, K24 DK62849 from the National Institute of Diabetes, Digestive and Kidney Diseases and Clinical Translational Science Award 1UL-1RR024975 from the National Center for Research Resources.
L.B.P. is currently an employee of Mitsubishi Tanabe Pharma Development America and declares no conflict of interest with regard to involvement with commercial entities that supply nutritional supplements.
ABSTRACT