Hemodialysis: Exercise inhibits inflammation on cellular level
Cardiovascular disease is the most common cause of mortality, not “just” in the general population, but also in patients undergoing hemodialysis (HD).
Markers of chronic inflammation are highly predictive for the disease. It has been suggested that regular exercise has anti-inflammatory effects, but this association has not been adequately investigated in HD patients, say English researchers at the University of Leicester and Loughborough University (Dungey M et al, Regular exercise during haemodialysis promotes an anti-inflammatory leucocyte profile. Clin Kidney J. 2017;10:813-821). The aim of the present small study was to assess the effect of regular intradialytic exercise on soluble inflammatory factors and inflammatory leucocyte phenotypes. The results indicate that regular intradialytic exercise is associated with an anti-inflammatory effect, but only at a circulating cellular level (not in circulating cytokines). The authors conclude that exercise may be protective against the increased risk of cardiovascular disease and mortality in HD patients as well.
22 patients performed intradialytic cycling three times a week for at least 30 minutes, while 16 HD patients simply received usual care without cycling. The authors assessed physical function, soluble inflammatory markers and leucocyte phenotypes after six months.
After six months, exercising patients had a lower proportion of intermediate monocytes than non-exercisers (7.58% to 6.38% versus 6.86% to 7.88%; P < 0.01). Only non-exercising patients showed a decrease in numbers (but not proportion) of regulatory T cells (P < 0.05). By contrast, training had no significant effect on circulating IL-6, CRP or TNF-α concentrations.
Regular exercise between dialysis sessions is associated with an anti-inflammatory effect. Regular exercise may therefore be protective against the increased risk of cardiovascular disease and mortality associated with elevated numbers of intermediate monocytes in patients undergoing hemodialysis.
Link to the study: https://academic.oup.com/ckj/article/10/6/813/3089987