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Regular exercise during haemodialysis promotes an anti-inflammatory leucocyte profile
journal contribution
posted on 2017-03-10, 13:49 authored by Maurice Dungey, Hannah M.L. Young, Darren R. Churchward, James O. Burton, Alice C. Smith, Nicolette BishopNicolette BishopBackground
Cardiovascular disease (CVD) is the most common cause of mortality in haemodialysis (HD) patients and is highly predicted by markers of chronic inflammation. Regular exercise may have beneficial anti-inflammatory effects, but this is unclear in HD patients. This study assessed the effect of regular intradialytic exercise on soluble inflammatory factors and inflammatory leukocyte phenotypes.
Methods
Twenty-two HD patients from a centre where intradialytic cycling was offered thrice-weekly and 16 HD patients receiving usual care volunteered. Exercising patients aimed to cycle for 30 min at RPE of “somewhat hard”. Baseline characteristic were compared with 16 healthy age-matched individuals. Physical function, soluble inflammatory markers and leukocyte phenotypes were assessed again after 6 months of regular exercise.
Results
Patients were less active than their healthy counterparts and had significant elevations in
measures of inflammation (IL-6, CRP, TNF-α, intermediate and non-classical monocytes; all
P<0.001). Six months of regular intradialytic exercise improved physical function (sit-to-stand 60). After 6 months the proportion of intermediate monocytes in the exercising patients reduced compared to non-exercisers (7.58±1.68 to 6.38±1.81% vs. 6.86±1.45 to 7.88±1.66%; P<0.01). Numbers (but not proportion) of regulatory T cells decreased in the non-exercising patients only (P<0.05). Training had no significant effect on circulating IL-6, CRP or TNF-α concentrations.
Conclusions
These findings suggest regular intradialytic exercise is associated with an anti-inflammatory effect at a circulating cellular level but not in circulating cytokines. This may be protective against the increased risk of CVD and mortality that is associated with chronic inflammation and elevated numbers of intermediate monocytes.
Funding
The work was generously funded by the Stoneygate Trust and the Leicester Kidney Care Appeal, and supported by the National Institute for Health Research (NIHR) Diet, Lifestyle & Physical Activity Biomedical Research Unit based at University Hospitals of Leicester and Loughborough University.
History
School
- Sport, Exercise and Health Sciences
Published in
Clinical Kidney JournalVolume
10Issue
6Pages
813-821Citation
DUNGEY, M. ... et al, 2017. Regular exercise during haemodialysis promotes an anti-inflammatory leukocyte profile. Clinical Kidney Journal, 10(6), pp. 813-821.Publisher
© The Authors. Published by Oxford University PressVersion
- VoR (Version of Record)
Publisher statement
This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc/4.0/Acceptance date
2017-02-15Publication date
2017-03-27Copyright date
2017Notes
This is an Open Access Article. It is published by OUP under the Creative Commons Creative Attribution-Non commercial license (CC BY-NC). Full details of this licence are available at: http://creativecommons.org/licenses/by-nc/4.0/ISSN
2048-8505eISSN
2048-8513Publisher version
Language
- en