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Wolf JM, Stefanovski D, Silverstein DC. Retrospective evaluation of the influence of azotemia on plasma lactate concentrations in hypotensive dogs and cats (2008-2018): 337 cases. J Vet Emerg Crit Care (San Antonio) 2020; 30:449-454. [PMID: 32579283 DOI: 10.1111/vec.12982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 09/10/2018] [Accepted: 09/14/2018] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the relationship between azotemia and plasma lactate concentration in hypotensive dogs and cats presented to an emergency department. DESIGN Retrospective case-control study. SETTING University veterinary teaching hospital. ANIMALS The electronic medical record database was searched for dogs and cats presented to the emergency department that had severe azotemia (creatinine ≥ 443.1 μmol/L [5 mg/dL]), hypotension (systolic blood pressure ≤ 90 mm Hg), and a plasma lactate measurement within 2 h of each another. Non-azotemic, normotensive dogs and cats; non-azotemic, hypotensive dogs and cats; and azotemic, normotensive dogs and cats that presented to the emergency department were used as control populations. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Severely azotemic, hypotensive dogs (n = 10) and cats (n = 63) had a lower plasma lactate than non-azotemic, hypotensive dogs and cats (P = 0.031 and P < 0.001, respectively). Median plasma lactate concentrations in hypotensive dogs (1.75 mmol/L) and cats (1.90 mmol/L) with severe azotemia were within reference intervals. CONCLUSIONS Hypotensive dogs and cats with severe azotemia have decreased plasma lactate concentrations as compared to hypotensive, non-azotemic dogs and cats. The median plasma lactate in azotemic, hypotensive dogs and cats was within reference intervals. This may be due to either decreased cellular production of lactate or increased excretion of lactate. Further research is needed to determine which of these mechanisms is responsible and the clinical significance of plasma lactate concentrations in azotemic, hypotensive dogs and cats.
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Affiliation(s)
- Jacob M Wolf
- Department of Clinical Studies and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Darko Stefanovski
- Department of Clinical Studies and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
| | - Deborah C Silverstein
- Department of Clinical Studies and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA
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2
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Lactate biosensing: The emerging point-of-care and personal health monitoring. Biosens Bioelectron 2018; 117:818-829. [DOI: 10.1016/j.bios.2018.06.054] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 06/26/2018] [Indexed: 11/19/2022]
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3
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Hofmann P. Cancer and Exercise: Warburg Hypothesis, Tumour Metabolism and High-Intensity Anaerobic Exercise. Sports (Basel) 2018; 6:sports6010010. [PMID: 29910314 PMCID: PMC5969185 DOI: 10.3390/sports6010010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/24/2018] [Accepted: 01/29/2018] [Indexed: 12/22/2022] Open
Abstract
There is ample evidence that regular moderate to vigorous aerobic physical activity is related to a reduced risk for various forms of cancer to suggest a causal relationship. Exercise is associated with positive changes in fitness, body composition, and physical functioning as well as in patient-reported outcomes such as fatigue, sleep quality, or health-related quality of life. Emerging evidence indicates that exercise may also be directly linked to the control of tumour biology through direct effects on tumour-intrinsic factors. Beside a multitude of effects of exercise on the human body, one underscored effect of exercise training is to target the specific metabolism of tumour cells, namely the Warburg-type highly glycolytic metabolism. Tumour metabolism as well as the tumour–host interaction may be selectively influenced by single bouts as well as regularly applied exercise, dependent on exercise intensity, duration, frequency and mode. High-intensity anaerobic exercise was shown to inhibit glycolysis and some studies in animals showed that effects on tumour growth might be stronger compared with moderate-intensity aerobic exercise. High-intensity exercise was shown to be safe in patients; however, it has to be applied carefully with an individualized prescription of exercise.
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Affiliation(s)
- Peter Hofmann
- Institute of Sports Sciences, Exercise Physiology, Training & Training Therapy Research Group, University of Graz, Max Mell Allee 11, Graz 8010, Austria.
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4
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Schardong J, Dipp T, Bozzeto CB, da Silva MG, Baldissera GL, Ribeiro RDC, Valdemarca BP, do Pinho AS, Sbruzzi G, Plentz RDM. Effects of Intradialytic Neuromuscular Electrical Stimulation on Strength and Muscle Architecture in Patients With Chronic Kidney Failure: Randomized Clinical Trial. Artif Organs 2017. [DOI: 10.1111/aor.12886] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Jociane Schardong
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Thiago Dipp
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Camila Bassani Bozzeto
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Marília Godoy da Silva
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Gabriela Leivas Baldissera
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Raíssa de Castro Ribeiro
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Bruna Pan Valdemarca
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Alexandre Severo do Pinho
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
| | - Graciele Sbruzzi
- Departamento de Fisioterapia, Programa de Pós-graduação em Ciências do Movimento; Universidade Federal do Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - Rodrigo Della Méa Plentz
- Departamento de Fisioterapia, Programa de Pós-graduação de Ciências da Saúde de Porto Alegre; Universidade Federal de Ciências da Saúde de Porto Alegre; Rio Grande do Sul Brazil
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5
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Stray-Gundersen J, Howden EJ, Parsons DB, Thompson JR. Neither Hematocrit Normalization nor Exercise Training Restores Oxygen Consumption to Normal Levels in Hemodialysis Patients. J Am Soc Nephrol 2016; 27:3769-3779. [PMID: 27153927 DOI: 10.1681/asn.2015091034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 03/22/2016] [Indexed: 12/15/2022] Open
Abstract
Patients treated with hemodialysis develop severely reduced functional capacity, which can be partially ameliorated by correcting anemia and through exercise training. In this study, we determined perturbations of an erythroid-stimulating agent and exercise training to examine if and where limitation to oxygen transport exists in patients on hemodialysis. Twenty-seven patients on hemodialysis completed a crossover study consisting of two exercise training phases at two hematocrit (Hct) values: 30% (anemic) and 42% (physiologic; normalized by treatment with erythroid-stimulating agent). To determine primary outcome measures of peak power and oxygen consumption (VO2) and secondary measures related to components of oxygen transport and utilization, all patients underwent numerous tests at five time points: baseline, untrained at Hct of 30%, after training at Hct of 30%, untrained at Hct of 42%, and after training at Hct of 42%. Hct normalization, exercise training, or the combination thereof significantly improved peak power and VO2 relative to values in the untrained anemic phase. Hct normalization increased peak arterial oxygen and arteriovenous oxygen difference, whereas exercise training improved cardiac output, citrate synthase activity, and peak tissue diffusing capacity. However, although the increase in arterial oxygen observed in the combination phase reached a value similar to that in healthy sedentary controls, the increase in peak arteriovenous oxygen difference did not. Muscle biopsy specimens showed markedly thickened endothelium and electron-dense interstitial deposits. In conclusion, exercise and Hct normalization had positive effects but failed to normalize exercise capacity in patients on hemodialysis. This effect may be caused by abnormalities identified within skeletal muscle.
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Affiliation(s)
- James Stray-Gundersen
- Department of Internal Medicine University of Texas Southwestern Medical Center, Dallas, Texas
| | - Erin J Howden
- Department of Internal Medicine University of Texas Southwestern Medical Center, Dallas, Texas; .,Institute for Exercise and Environmental Medicine, Texas Health Resources, Dallas, Texas; and
| | - Dora Beth Parsons
- Department of Internal Medicine University of Texas Southwestern Medical Center, Dallas, Texas
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6
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Andrus LP, Unruh R, Wisniewski NA, McShane MJ. Characterization of Lactate Sensors Based on Lactate Oxidase and Palladium Benzoporphyrin Immobilized in Hydrogels. BIOSENSORS 2015; 5:398-416. [PMID: 26198251 PMCID: PMC4600164 DOI: 10.3390/bios5030398] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/16/2015] [Accepted: 06/24/2015] [Indexed: 12/18/2022]
Abstract
An optical biosensor for lactate detection is described. By encapsulating enzyme-phosphor sensing molecules within permeable hydrogel materials, lactate-sensitive emission lifetimes were achieved. The relative amount of monomer was varied to compare three homo- and co-polymer materials: poly(2-hydroxyethyl methacrylate) (pHEMA) and two copolymers of pHEMA and poly(acrylamide) (pAam). Diffusion analysis demonstrated the ability to control lactate transport by varying the hydrogel composition, while having a minimal effect on oxygen diffusion. Sensors displayed the desired dose-variable response to lactate challenges, highlighting the tunable, diffusion-controlled nature of the sensing platform. Short-term repeated exposure tests revealed enhanced stability for sensors comprising hydrogels with acrylamide additives; after an initial "break-in" period, signal retention was 100% for 15 repeated cycles. Finally, because this study describes the modification of a previously developed glucose sensor for lactate analysis, it demonstrates the potential for mix-and-match enzyme-phosphor-hydrogel sensing for use in future multi-analyte sensors.
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Affiliation(s)
- Liam P Andrus
- Department of Biomedical Engineering, 5045 Emerging Technologies Building, 3120 TAMU, Texas A&M University, College Station, TX 77843, USA.
| | - Rachel Unruh
- Department of Biomedical Engineering, 5045 Emerging Technologies Building, 3120 TAMU, Texas A&M University, College Station, TX 77843, USA.
| | | | - Michael J McShane
- Department of Biomedical Engineering, 5045 Emerging Technologies Building, 3120 TAMU, Texas A&M University, College Station, TX 77843, USA.
- Department of Materials Science and Engineering, 3003 TAMU, Texas A&M University, College Station, TX 77843, USA.
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7
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Goodwin ML, Harris JE, Hernández A, Gladden LB. Blood lactate measurements and analysis during exercise: a guide for clinicians. J Diabetes Sci Technol 2007; 1:558-69. [PMID: 19885119 PMCID: PMC2769631 DOI: 10.1177/193229680700100414] [Citation(s) in RCA: 283] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Blood lactate concentration ([La(-)](b)) is one of the most often measured parameters during clinical exercise testing as well as during performance testing of athletes. While an elevated [La(-)](b) may be indicative of ischemia or hypoxemia, it may also be a "normal" physiological response to exertion. In response to "all-out" maximal exertion lasting 30-120 seconds, peak [La(-)](b) values of approximately 15-25 mM may be observed 3-8 minutes postexercise. In response to progressive, incremental exercise, [La(-)](b) increases gradually at first and then more rapidly as the exercise becomes more intense. The work rate beyond which [La(-)](b) increases exponentially [the lactate threshold (LT)] is a better predictor of performance than V O2max and is a better indicator of exercise intensity than heart rate; thus LT (and other valid methods of describing this curvilinear [La(-)](b) response with a single point) is useful in prescribing exercise intensities for most diseased and nondiseased patients alike. H(+)-monocarboxylate cotransporters provide the primary of three routes by which La(-) transport proceeds across the sarcolemma and red blood cell membrane. At rest and during most exercise conditions, whole blood [La(-)] values are on average 70% of the corresponding plasma [La(-)] values; thus when analyzing [La(-)](b'), care should be taken to both (1) validate the [La(-)](b)-measuring instrument with the criterion/reference enzymatic method and (2) interpret the results correctly based on what is being measured (plasma or whole blood). Overall, it is advantageous for clinicians to have a thorough understanding of [La(-)](b) responses, blood La(-) transport and distribution, and [La(-)](b) analysis.
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Affiliation(s)
- Matthew L Goodwin
- Department of Kinesiology, Auburn University, Auburn, Alabama 36849-5323, USA.
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8
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Couto CI. Resistance exercise training improves strength and quality of life in patients undergoing haemodialysis. THE AUSTRALIAN JOURNAL OF PHYSIOTHERAPY 2007; 53:288. [PMID: 18246636 DOI: 10.1016/s0004-9514(07)70014-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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9
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Kouidi EJ. Central and peripheral adaptations to physical training in patients with end-stage renal disease. Sports Med 2002; 31:651-65. [PMID: 11508521 DOI: 10.2165/00007256-200131090-00002] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Renal replacement treatment options are life-saving treatments for patients with end-stage renal disease (ESRD). However, prolonged survival in patients with ESRD is associated with various functional and morphological disorders from almost all systems. Anaemia, deconditioning, cardiac dysfunction. impairment of cardiac autonomic control and skeletal muscle weakness and fatigue, primarily because of 'uraemic' myopathy and neuropathy, are the main predisposing factors for their poor functional ability. Physical training is being recommended as a complementary therapeutic modality. There are generally 3 methods of exercise training applied in patients with ESRD: (i) the supervised outpatient programme that is held in a rehabilitation centre; (ii) a home exercise rehabilitation programme; and (iii) exercise rehabilitation programme during the first hours of the haemodialysis treatment in the renal unit. All the available training data show that the application of an exercise training programme in patients with ESRD enhances their physical fitness. This improvement is due to central and mainly peripheral adaptations. Exercise training in these patients increases aerobic capacity, causes favourable left ventricular functional adaptations, reduces blood pressure in patients with hypertension, modifies other coronary risk factors, increases the cardiac vagal activity and suppresses the incidence of cardiac arrhythmias. Moreover, exercise training has beneficial effects on muscle structural and functional abnormalities. These central and peripheral adaptations to exercise training cause an increase in their functional capacity and offer them achance of a better quality of life. Moreover, exercise training improves exercisee tolerance of renal post-transplant patients.
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Affiliation(s)
- E J Kouidi
- Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, Greece.
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10
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Heiwe S, Jacobson SH. Exercise training for adults with chronic kidney disease. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2001. [DOI: 10.1002/14651858.cd003236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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11
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Diesel W, Emms M, Knight BK, Noakes TD, Swanepoel CR, van Zyl Smit R, Kaschula RO, Sinclair-Smith CC. Morphologic features of the myopathy associated with chronic renal failure. Am J Kidney Dis 1993; 22:677-84. [PMID: 8238013 DOI: 10.1016/s0272-6386(12)80430-6] [Citation(s) in RCA: 116] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Our previous studies indicate that impaired function of skeletal muscle limits the exercise tolerance of patients with end-stage renal failure who are either maintained on dialysis or undergo renal transplantation. To study the morphology of the condition, muscle biopsies were performed on eight patients with renal failure-associated myopathy. Control samples were taken from seven healthy athletes undergoing knee surgery and from five otherwise healthy but untrained subjects. Tissues were examined by routine light and transmission electron microscopy. Histochemical staining of frozen sections for myosin adenosine triphosphatase and quantitative computer-assisted morphometry of the fiber type and size was performed. The mean (+/- SD) size for type I fibers in patients was 61.2 +/- 11.8 microns, while type II fibers measured 46.7 +/- 11.4 microns. The mean percentage of type II fibers was 67% +/- 12%. These values are within the normal population range and were not different from controls. Significant changes were found on light microscopy of patient samples. These included fiber splitting, internalized nuclei, nuclear knots, moth-eaten fibers, fiber degeneration and regeneration, increased content of lipid droplets, and fiber-type grouping. Electron microscopy showed a large variety of nonspecific abnormalities, including mitochondrial changes, Z-band degeneration, myofilament loss, and accumulation of intracellular glycogen. Ten of 12 control subjects showed no such changes; minor abnormalities were noted on both light and electron microscopy in the remaining two subjects. Muscle oxidative capacity (19.5 +/- 5.1 microL O2/min) for patients with end-stage renal failure was not different from values for those who had undergone renal transplantation, but was lower than values found in trained athletes.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- W Diesel
- Department of Physiology, University of Cape Town Medical School, South Africa
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12
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Moore GE, Parsons DB, Stray-Gundersen J, Painter PL, Brinker KR, Mitchell JH. Uremic myopathy limits aerobic capacity in hemodialysis patients. Am J Kidney Dis 1993; 22:277-87. [PMID: 8352254 DOI: 10.1016/s0272-6386(12)70319-0] [Citation(s) in RCA: 138] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Eleven end-stage renal disease patients trained by stationary cycling during their hemodialysis treatments. After a 6-week control period, 12 weeks of training began and was increased to 30 to 60 minutes at > or = 70% of peak heart rate. Baseline, pretraining and, posttraining exercise tests were performed. Workload (WL), oxygen uptake (VO2peak), cardiac output (Q), heart rate (HR), and arterial oxygen content (CaO2) were measured. Stroke volume (SV), arteriovenous oxygen difference ((a-v)O2), and mixed-venous oxygen content (CvO2) were calculated. Rectus femoris biopsies were obtained pretraining and posttraining. At peak exercise, WL increased from 60 +/- 4 to 70 +/- 6 W (P < 0.05), VO2peak showed an upward trend from 14.8 +/- 0.9 to 16.8 +/- 1.3 mL/kg/min (P < 0.1), and Q, HR, SV, CaO2, CvO2, and (a-v)O2 were unchanged. Ten of the 11 patients increased WL, but only six increased VO2peak (five of 11 patients decreased VO2peak). The difference between groups (P < 0.02) was attributable to (a-v)O2, which increased in those who increased VO2peak (P < 0.02). There was an upward trend for succinate dehydrogenase activity (P < 0.06), and phosphofructokinase activity increased (P < 0.05). However, the rectus femoris capillary to fiber ratio, type I and II fiber areas, and fiber area variability were unchanged, and neither histomorphologic nor enzymatic activity changes were related to change in VO2peak. We conclude that not all dialysis patients increase VO2peak after training, but most can improve exercise capacity. Patients who improved VO2peak widened their (a-v)O2 difference, increasing oxygen extraction and showing that oxygen delivery is not always the limiting factor. Thus, the limitation of VO2peak in dialysis patients is a complex interaction of central and peripheral factors. Muscle therapies, such as exercise training, are needed in addition to increased oxygen delivery in rehabilitation of dialysis patients.
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Affiliation(s)
- G E Moore
- Moss Heart Center, University of Texas Southwestern Medical Center, Dallas 75235
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13
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Tomson CR, Channon SM, Ward MK, Laker MF. Ascorbate-induced hyperoxalaemia has no significant effect on lactate generation or erythrocyte 2,3,diphosphoglycerate in dialysis patients. Eur J Clin Invest 1990; 20:411-5. [PMID: 2121500 DOI: 10.1111/j.1365-2362.1990.tb01878.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To examine the possible effects of hyperoxalaemia on anaerobic metabolism and erythrocyte pyruvate kinase activity, we induced a rise in plasma oxalate in 11 dialysis patients by the oral administration of ascorbic acid, 500 mg day-1 for 3 weeks. Blood samples were taken from the same antecubital vein before and after the supplementation period, without venous stasis, after an overnight fast. This protocol allowed patients to be used as their own controls. Five healthy subjects underwent an identical protocol to exclude any effect of ascorbate per se. Mean (SEM) plasma oxalate (mumol l-1) rose from 30.3 (3.5) to 48.4 (6.1) in patients and from 1.4 (0.2) to 6.8 (0.9) in healthy subjects. Whole blood ascorbate (mg l-1) rose from 7.0 (0.7) to 26.6 (2.5) in patients and from 9.3 (1.2) to 17.8 (1.8) in healthy subjects (reference range 7.5-20.0 mg l-1). No changes were observed in either group in plasma creatinine, bicarbonate, haemoglobin, or erythrocyte 2,3,diphosphoglycerate (2,3 DPG) after the 3 week supplementation period. Before supplementation lactate generation (area under curve, mmol min l-1) in the 5 min following a 60 s period of standardized ischaemic forearm exercise was significantly (P = 0.026) greater in patients [69.1 (4.7)] than in healthy subjects [46.9 (6.7)]; no significant change in lactate generation occurred in either group after ascorbate-induced hyperoxalaemia. We conclude that changes in plasma oxalate of the order of 20 mumol l-1 have no significant effect on lactate generation or 2,3,DPG levels in uraemic subjects.
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Affiliation(s)
- C R Tomson
- Department of Medicine, University of Newcastle upon Tyne, UK
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14
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Latos DL, Strimel D, Drews MH, Allison TG. Acid-base and electrolyte changes following maximal and submaximal exercise in hemodialysis patients. Am J Kidney Dis 1987; 10:439-45. [PMID: 3120580 DOI: 10.1016/s0272-6386(87)80190-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Maximal treadmill exercise was conducted in nine hemodialysis patients and in 15 unconditioned healthy subjects. Exercise capacity in the dialysis patients, as measured by duration of exercise, maximal oxygen consumption (VO2 max), and workload achieved (METS) was approximately 50% of that of the nonuremic volunteers. Four of the dialysis patients were studied on both dialysis (predialysis) and nondialysis days and also at 60% of VO2 max for 30 minutes on a nondialysis day. In these individuals, serum electrolytes, acid-base, and biochemical parameters were analyzed preexercise and at regular intervals following cessation of treadmill exercise. Transient metabolic acidosis and mild hyperkalemia developed after maximal exercise but not after prolonged submaximal exercise. Patients were slightly more acidotic and hyperkalemic on a dialysis day compared to a nondialysis day. Cardiopulmonary performance was similar on both days. These changes in serum electrolytes and acid-base parameters provide documentation of the extent of biochemical changes that develop following exercise in dialysis patients.
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Affiliation(s)
- D L Latos
- Division of Hypertension and Nephrology, Wheeling Clinic, West Virginia
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15
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Painter P, Hanson P, Messer-Rehak D, Zimmerman SW, Glass NR. Exercise tolerance changes following renal transplantation. Am J Kidney Dis 1987; 10:452-6. [PMID: 2891297 DOI: 10.1016/s0272-6386(87)80192-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Maximal exercise capacity was measured in 20 nondiabetic patients with end-stage renal disease before and soon after successful renal transplantation. Maximal oxygen consumption increased significantly in all patients posttransplant. Increases in maximal heart rate and heart rates at 70% of maximal levels were also observed. The changes in maximal oxygen consumption were not significantly correlated with changes in hematocrit. The removal of uremia may result in improved functioning of one or more of the systems involved in oxygen transport and utilization that determine exercise capacity.
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Affiliation(s)
- P Painter
- Department of Medicine, University of Wisconsin, Madison
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Abstract
Energy-rich phosphagens were measured in 11 patients with end-stage chronic renal failure and 11 nonuremic subjects. A significant decrease of ATP, phosphocreatine, total adenine nucleotides, lactate, and energy charge was found. The present results can be referred both to glycolytic sequence disturbances and to the lack of substrates characteristic of uremia.
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Del Canale S, Fiaccadori E, Coffrini E, Vitali P, Ronda N, Antonucci C, Arduini U, Guariglia A. Uremic acidosis and intracellular buffering. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 1986; 20:301-6. [PMID: 3810060 DOI: 10.3109/00365598609024516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Skeletal muscle biopsies were performed in 16 controls and 15 non-dialysed end-stage chronic renal failure (CRF) patients presenting untreated metabolic acidosis. Intracellular bicarbonate, pH, water compartments and electrolytes were determined. In 8 of 15 patients muscle ATP and lactate were measured. Intracellular bicarbonate (HCO3i) and pH (pHi) were obtained by means of muscle total carbon dioxide method: a significant (p less than 0.001) reduction in both intracellular acid--base indexes was found in all patients (pHi 6.82 +/- 13 vs. 7.04 +/- 0.05; HCO3i 6.28 +/- 2.07 vs. 11.86 +/- 0.87). Total muscle as well as extracellular water was increased. Muscle sodium and chloride contents were also increased, while no change in potassium and magnesium was detected. A significant decrease of both muscle ATP and lactate was found. The data lead to the conclusion that chronic retention of acids in CRF results in a depletion of the muscle buffer pool and consequently in intracellular acidosis: the latter could be the main cause of the cell energy metabolism derangement described in uremia.
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Abstract
The blood lactate response to exercise has interested physiologists for over fifty years, but has more recently become as routine a variable to measure in many exercise laboratories as is heart rate. This rising popularity is probably due to: the ease of sampling and improved accuracy afforded by recently developed micro-assay methods and/or automated lactate analysers; and the predictive and evaluative power associated with the lactate response to exercise. Several studies suggest that the strong relationship between exercise performance and lactate-related variables can be attributed to a reflection by lactate during exercise of not only the functional capacity of the central circulatory apparati to transport oxygen to exercising muscles, but also the peripheral capacity of the musculature to utilise this oxygen. For example, several studies contrast the relationship between VO2max and endurance running performance with that between a lactate variable and the same running performance. In every study, the lactate variable is more highly correlated with performance. Similarly, prescribing training intensity as a function of the lactate concentration elicited by the training may prove to be a means of obtaining a more homogeneous adaptation to training in a group of athletes or subjects than is obtained by setting intensity as a function of maximal heart rate or % VO2max. A review of the recent literature shows that the lactate response to supramaximal exercise is a sensitive indicator of adaptation to 'sprint training' and is correlated with supramaximal exercise performance. This review also describes the possible applications of lactate measurements to enhance the rate of recovery from high intensity exercise. Although the lactate response to exercise is reproducible under standardised conditions it can be influenced by the site of blood sampling, ambient temperature, changes in the body's acid-base balance prior to exercise, prior exercise, dietary manipulations, or pharmacological interpretation.
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Guarnieri GF, Toigo G, Situlin R, Faccini L, Rustia R, Dardi F. Muscle cathepsin D activity, and RNA, DNA and protein content in maintenance hemodialysis patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1984; 167:533-43. [PMID: 6201051 DOI: 10.1007/978-1-4615-9355-3_47] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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