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Lian Y, Geng T, Wang J, Yu Q, Jin J, Li T, Wen H. Effect of electric function training instrument for arteriovenous fistula on vascular index of fistula and puncture success rate in patients with autogenous arteriovenous fistulization. Biotechnol Genet Eng Rev 2024; 40:1726-1736. [PMID: 36999774 DOI: 10.1080/02648725.2023.2196481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/23/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVE To explore the effect of electric function training instrument for arteriovenous fistula on vascular index of fistula and puncture success rate in patients with autogenous arteriovenous fistulization (AVF). METHODS 60 patients received AVF in the Fourth Hospital of Hebei Medical University from June 2020 to June 2021 were selected as the study subjects, and they were divided into the treatment group (TG, n = 30) and the reference group (RG, n = 30) according to the random number table method. The patients in the RG received routine pressure training by clench fist and tourniquet after surgery, and the TG used electric function training instrument for arteriovenous fistula on the basis of routine clench fist, then comprehensively evaluating the clinical application value of this study protocol by comparing the vascular index of fistula and puncture success rate of the two groups. RESULTS The depth of cephalic vein to skin at T2 and T3 in the TG was notably lower than the RG (P < 0.05), and the vessel diameter of cephalic vein at T3 in the TG was visibly higher than the RG (P < 0.05), with no overt difference in the rate of fistula complication, one-time puncture success rate and the incidence of puncture injury in both groups (P > 0.05). The score of functional exercise compliance of fistula in the TG was clearly higher than the RG (P < 0.001). CONCLUSION The study results suggest that the use of electric function training instrument for arteriovenous fistula after AVF is more effective, so it has certain clinical application value.
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Affiliation(s)
- Yanmin Lian
- Department of Nephrology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tonghui Geng
- Department of Nephrology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jing Wang
- Department of Nephrology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qian Yu
- Department of Nephrology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jingjing Jin
- Department of Nephrology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tongmiao Li
- Department of Nephrology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Han Wen
- Physical Examination Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Ben-Noach D, Levy D, Raz M, Anbar R, Schwartz D, Kliuk-Ben Bassat O. Assessment of the Correlation Between Serum Phosphate Level and Muscle Strength as Measured by Handgrip Strength in Patients Treated With Hemodialysis. Can J Kidney Health Dis 2024; 11:20543581241267163. [PMID: 39114646 PMCID: PMC11304484 DOI: 10.1177/20543581241267163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/05/2024] [Indexed: 08/10/2024] Open
Abstract
Background Sarcopenia, commonly observed in patients treated with hemodialysis, correlates with low serum phosphate levels. Although normophosphatemia is desired, dietary phosphate restriction is difficult to achieve and may result in undesirable protein restriction. Objective We aimed to evaluate whether hyperphosphatemia is associated with higher muscle strength in patients receiving hemodialysis treatment. Design A single-center prospective observational study. Setting Ambulatory prevalent patients undergoing hemodialysis treatments in a dialysis unit of a tertiary hospital. Patients Participants included prevalent patients treated with hemodialysis. All patients were above 18 years. Only patients with residual kidney function below 200 mL/24 hours were included to avoid bias. Measurements Muscle strength was measured by handgrip strength (HGS). Each patient repeated 3 measurements, and the highest value was recorded. Handgrip strength cutoffs for low muscle strength were defined as <27 kg in men and <16 kg in women. Biochemical parameters, including serum phosphate level, were driven from routine monthly blood tests. Hyperphosphatemia was defined as serum phosphate above 4.5 mg/dL. Methods Handgrip strength results were compared to nutritional, anthropometric, and biochemical parameters-in particular phosphate level. Long-term mortality was recorded. Results Seventy-four patients were included in the final analysis. Handgrip strength was abnormally low in 33 patients (44.5%). Patients with abnormal HGS were older and more likely to have diabetes mellitus and lower albumin and creatinine levels. There was no correlation between HGS and phosphate level (r = 0.008, P = .945). On multivariable analysis, predictors of higher HGS were body mass index and creatinine. Diabetes mellitus and female sex predicted lower HGS. Hyperphosphatemia correlated with protein catabolic rate, blood urea nitrogen, and creatinine. On multivariable analysis, predictors of hyperphosphatemia were higher creatinine level, normal albumin level, and heart failure. During mean follow-up time of 7.66 ± 3.9 months, 11 patients died. Mortality was significantly higher in patients with abnormally low HGS compared with normal HGS (odds ratio = 9.32, P = .02). Limitations A single-center study. All measurements were performed at one time point without repeated assessments. Direct dietary intake, degree of physical activity, and medication compliance were not assessed. Conclusion Hyperphosphatemia correlated with increased protein intake as assessed by protein catabolic rate in patients treated with hemodialysis; however, neither correlated with higher muscle strength as measured by HGS.Trial registration: MOH 202125213.
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Affiliation(s)
- Dror Ben-Noach
- Department of Nutrition and Dietetic, Tel Aviv Sourasky Medical Center, Israel
| | - Dina Levy
- Department of Nutrition and Dietetic, Tel Aviv Sourasky Medical Center, Israel
| | - Michal Raz
- Department of Nephrology and Hypertension, Tel Aviv Sourasky Medical Center, Israel
| | - Ronit Anbar
- Department of Nutrition and Dietetic, Tel Aviv Sourasky Medical Center, Israel
| | - Doron Schwartz
- Department of Nephrology and Hypertension, Tel Aviv Sourasky Medical Center, Israel
- Faculty of Medicine, Tel Aviv University, Israel
| | - Orit Kliuk-Ben Bassat
- Department of Nephrology and Hypertension, Tel Aviv Sourasky Medical Center, Israel
- Faculty of Medicine, Tel Aviv University, Israel
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Takahashi R, Yabe H, Ishikawa H, Hibino T, Morishita S, Kono K, Moriyama Y, Yamada T. The impact of malnutrition on the effectiveness of intradialytic exercise in hemodialysis patients: amulticenter cohort study. Int Urol Nephrol 2024; 56:2093-2101. [PMID: 38334912 DOI: 10.1007/s11255-024-03952-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/06/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Low physical function can be effectively improved via intradialytic exercise. However, the association between the effects of intradialytic exercise on physical function and malnutrition severity has not been studied extensively. This study aimed to investigate the impact of nutritional status severity on physical function in patients undergoing hemodialysis with low physical function to whom intradialytic exercise was prescribed. METHODS The participants were patients with decreased mobility [walking speed < 1.0 m/s and/or Short Physical Performance Battery (SPPB) < 12] who had been undergoing hemodialysis thrice a week for 6 months and performing intradialytic exercise program. Patients were divided into groups based on the Geriatric Nutritional Risk Index (GNRI) [Non-malnutrition group (GNRI > 98), Gentle/slim malnutrition group (GNRI ≤ 98, GNRI ≥ 92), Mild malnutrition group (GNRI < 92, GNRI ≥ 82), Severe malnutrition group (GNRI < 82)]. The primary outcomes were Grip strength, isometric knee extension strength (IKES), SPPB, and 10-m walking speed measured at baseline and at 6 months. Statistical analyses were performed using a linear mixed-effects model with the intention-to-treat analysis, including within-group analysis and between-group comparison. RESULTS A total of 805 participants were included in the study. Within-group comparisons showed significantly improved IKES, 10-m walking speed, and SPPB improved, except in the Severe malnutrition group. Grip strength significantly improved in the Gentle/slim and mild malnutrition groups. Between-group comparison with controls showed that the improvement in Grip strength was significantly bigger in the Gentle/slim malnutrition group [0.98 (0.15 to 1.82) kg] than in the non-malnutrition group. However, IKES in the Severe malnutrition group [- 5.14 (- 9.18 to - 1.10) %] less significantly improve than that in the non-malnutrition group. No significant differences were found in the other indices. CONCLUSION In patients with severe malnutrition, the changes in IKES scores resulting from Intradialytic exercise were significantly smaller than those observed in non-malnourished patients. Therefore, it is necessary to initiate suitable nutritional and exercise therapy based on the severity of malnutrition.
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Affiliation(s)
- Ren Takahashi
- Department of Rehabilitation, Kaikoukai Josai Hospital, Nagoya, Aichi, Japan.
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Hamamatsu, Shizuoka, Japan.
| | - Hiroki Yabe
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Shizuka, Japan
| | - Hideaki Ishikawa
- Department of Internal Medicine, Kaikoukai Josai Hospital, Nagoya, Aichi, Japan
| | - Takashi Hibino
- Department of Rehabilitation, Kaikoukai Josai Hospital, Nagoya, Aichi, Japan
| | - Sayumi Morishita
- Department of Rehabilitation, Kaikoukai Josai Hospital, Nagoya, Aichi, Japan
| | - Kenichi Kono
- Department of Physical Therapy, International University of Health and Welfare School of Health Science at Narita, Narita, Chiba, Japan
| | - Yoshifumi Moriyama
- Department of Wellness Center, Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan
| | - Tetsuya Yamada
- Dialysis Division, Kaikoukai Healthcare Group, Nagoya, Aichi, Japan
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Tang R, Chen J, Ma H, Deng J, Zhang Y, Xu Q. The association between blood nickel level and handgrip strength in patients undergoing maintenance hemodialysis. Int Urol Nephrol 2024; 56:1487-1495. [PMID: 37851212 PMCID: PMC10924028 DOI: 10.1007/s11255-023-03836-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Progressive loss of peripheral muscle strength is highly pronounced in patients receiving maintenance hemodialysis (MHD), of which the pathological mechanism tends to be multifactorial. Plasma nickel was reportedly correlated with muscular strength in non-dialysis patients. However, scarce is known regarding the association between blood nickel level and handgrip strength among the patients undergoing MHD. METHODS This cross-sectional study included patients undergoing MHD at our center in October 2021. Blood samples were collected before the hemodialysis sessions. Nickel level was measured using inductively coupled plasma mass spectrometry. Eligible patients were stratified into three groups by the blood nickel level: tertile 1 (≥ 5.2 ug/L); tertile 2 (< 5.2 ug/L and ≥ 4.5 ug/L); and tertile 3 (< 4.5 ug/L). Handgrip strength measurement was used to evaluate the muscle status. Spearman's analyses and multivariable linear regression analyses were performed to study the relationship between blood nickel level and handgrip strength. RESULTS A total of 236 patients were enrolled, with an average age of 55.51 ± 14.27 years and a median dialysis vintage of 83 (IQR: 48-125) months. Patients in group with a higher blood nickel level (tertile 1) tended to be female, had longer dialysis vintage and higher Kt/V, but lower BMI, serum creatinine, hemoglobin, and handgrip strength level (all p < 0.05). After adjustment for confounding factors in multivariable models, for every 1ug/L increase in nickel level, the patient's handgrip strength decreases by 2.81 kg (β: - 2.810, 95% confidence interval: - 5.036 to - 0.584, p = 0.014). Restricted cubic spline confirmed the relationship was nearly linear. CONCLUSIONS Our study highlighted that blood nickel level was related to handgrip strength in patients undergoing MHD. Prospective studies with larger sample sizes are still needed to confirm the result.
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Affiliation(s)
- Ruiying Tang
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Jiexin Chen
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Huijuan Ma
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Jihong Deng
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Yanxia Zhang
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China
| | - Qingdong Xu
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China.
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Battaglia Y, Amicone M, Mantovani A, Combe C, Mitra S, Basile C. Home-based exercise in patients on maintenance dialysis: a systematic review and meta-analysis of randomized clinical trials. Nephrol Dial Transplant 2023; 38:2550-2561. [PMID: 37202219 DOI: 10.1093/ndt/gfad102] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND The impact of home-based exercise on physical performance and quality of life (QoL) in patients on maintenance dialysis has not yet been fully established. METHODS We searched four large electronic databases to identify randomized controlled trials (RCTs) reporting the impact of home-based exercise interventions vs. usual care or intradialytic exercise interventions, on physical performance and QoL in patients on dialysis. The meta-analysis was performed using fixed effects modeling. RESULTS We included 12 unique RCTs involving 791 patients of various ages on maintenance dialysis. Home-based exercise interventions were associated with an improvement of walking speed at the 6 Minutes Walking Test [6MWT; nine RCTs; pooled weighted mean differences (WMD): 33.7 m, 95% confidence interval (CI) 22.8-44.5; P < 0.001; I2 = 0%) and in aerobic capacity as assessed by the peak oxygen consumption (VO2 peak; 3 RCTs; pooled WMD: 2.04 ml/kg/min, 95% CI 0.25-3.83; P = 0.03; I2 = 0%). They were also associated with improved QoL, as assessed by the Short Form (36) Health (SF-36) score. Stratifying the RCTs by control groups, no significant difference was found between home-based exercise and intradialytic exercise interventions. Funnel plots did not reveal any significant publication bias. CONCLUSIONS Our systematic review and meta-analysis showed that home-based exercise interventions for 3-6 months were associated with significant improvements in physical performance in patients on maintenance dialysis. However, further RCTs with a longer follow-up should be conducted to assess the safety, adherence, feasibility, and effects on QoL of home-based exercise programs in dialysis patients.
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Affiliation(s)
- Yuri Battaglia
- University of Verona, Department of Medicine, Verona, Italy
- Pederzoli Hospital, Nephrology and Dialysis Unit, Peschiera del Garda, Italy
| | - Maria Amicone
- Department of Public Health, Chair of Nephrology, University of Naples Federico II, Italy
| | - Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Christian Combe
- Department of Nephrology, CHU de Bordeaux and INSERM U1026, University of Bordeaux, Bordeaux, France
| | - Sandip Mitra
- Manchester Academy of Health Sciences Centre (MAHSC), University Hospitals, Oxford Road, Manchester, UK
| | - Carlo Basile
- Associazione Nefrologica Gabriella Sebastio, Martina Franca, Italy
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Zelko A, Rosenberger J, Kolarcik P, Madarasova Geckova A, van Dijk JP, Reijneveld SA. Age and sex differences in the effectiveness of intradialytic resistance training on muscle function. Sci Rep 2023; 13:3491. [PMID: 36859437 PMCID: PMC9977769 DOI: 10.1038/s41598-023-30621-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/27/2023] [Indexed: 03/03/2023] Open
Abstract
Previous research shows the beneficial effects of an intradialytic resistance training (IRT) on muscle function in haemodialysis patients. However, patients vary highly in their functional responses to IRT, may be due to effects of age and sex heterogeneities in adaptation. Therefore, the aim of this study was to investigate the degree to which the effects of IRT on the muscle function of haemodialysis patients vary by age and sex. We included 57 patients who completed a 12-week IRT (EXG) and 33 patients who received no IRT (CNG) during haemodialysis. Muscle function (MF) was assessed using dynamometry before and after a 12-week intervention and after a 12-week follow-up. After the 12-week intervention, we found a moderation effect of age in the relative (%) change (p = 0.011) and absolute (Δ) change (p = 0.027) of MF, and a moderation effect of sex in %MF (p = 0.001), but not in ΔMF (p = 0.069). Regarding patients' age, the change of MF was only significantly different between EXG and CNG patients aged 60-70 years (%MF, EXG: + 34.6%, CNG: - 20.1%, p < 0.001; ΔMF, EXG: + 44.4 N, CNG: - 22.1 N, p < 0.001). Regarding patients' sex, the change of MF was only significantly different between EXG and CNG female patients (%MF, EXG: + 23.9%, CNG: - 23.6%, p < 0.001). Age and sex did not significantly moderate changes in MF measures after 12 weeks of follow-up. We conclude that both age and sex of haemodialysis patients affect their functional response to IRT in the short term.Trial Registration: Intradialytic Resistance Training in Haemodialysis Patients (IRTHEP)-#NCT03511924, 30/04/2018, https://clinicaltrials.gov/ct2/show/NCT03511924 .
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Affiliation(s)
- Aurel Zelko
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, 040 11, Kosice, Slovakia.
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, 040 11, Kosice, Slovakia.
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands.
| | - Jaroslav Rosenberger
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, 040 11, Kosice, Slovakia
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, 040 11, Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University Olomouc, 771 11, Olomouc, Czech Republic
- 2nd Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, 040 11, Kosice, Slovakia
- Fresenius Medical Care-Dialysis Services Kosice, 040 11, Kosice, Slovakia
| | - Peter Kolarcik
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, 040 11, Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University Olomouc, 771 11, Olomouc, Czech Republic
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, 040 11, Kosice, Slovakia
- Olomouc University Social Health Institute, Palacky University Olomouc, 771 11, Olomouc, Czech Republic
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University in Bratislava, 821 05, Bratislava, Slovakia
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, 040 11, Kosice, Slovakia
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands
- Olomouc University Social Health Institute, Palacky University Olomouc, 771 11, Olomouc, Czech Republic
| | - Sijmen A Reijneveld
- Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, The Netherlands
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Azzeh FS, Turkistani WM, Ghaith MM, Bahubaish LA, Kensara OA, Almasmoum HA, Aldairi AF, Khan AA, Alghamdi AA, Shamlan G, Alhussain MH, Algheshairy RM, AlShahrani AM, Qutob MS, Alazzeh AY, Qutob HM. Factors associated with the prevalence of malnutrition among adult hemodialytic patients: A two-center study in the Jeddah region, Saudi Arabia. Medicine (Baltimore) 2022; 101:e30757. [PMID: 36221328 PMCID: PMC9542565 DOI: 10.1097/md.0000000000030757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Chronic kidney disease, one of the most common diseases in the world, is characterized by irreversible impairment of the kidney's metabolic, excretory, and endocrine functions. During end-stage renal disease, patients require renal replacement therapy, such as hemodialysis (HD). Protein-energy wasting is a common health problem among HD patients. This study aims to assess the nutritional status of HD patients at two HD centers in Jeddah, Saudi Arabia, and to determine its associated factors. A cross-sectional study was conducted at two different dialysis centers in Jeddah, Saudi Arabia; 211 female and male HD patients. Malnutrition was recognized using the modified-subjective global assessment (M-SGA) comprising two parts: medical history and physical examination. Sociodemographic and health status for all patients were also determined. Patients were classified based on their M-SGA score into two groups: normal and malnourished. Overall, 54.5% of the participants showed malnutrition. Unemployment, low muscle strength and mass, high level of medication use, and high dialysis vintage were positively (P < .05) associated with malnutrition. In conclusion, the M-SGA score indicates a high prevalence of malnutrition among HD patients. These results show the importance of regular assessment and follow-ups for HD patients ensuring better health and nutritional status.
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Affiliation(s)
- Firas S. Azzeh
- Clinical Nutrition Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- *Correspondence: Firas Azzeh, Clinical Nutrition Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah 24231, Saudi Arabia (e-mail: )
| | - Waad M. Turkistani
- Clinical Nutrition Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- Clinical Nutrition Department, Diaverum A.B. Prince Abdulmajeed Dialysis Center, Jeddah, Saudi Arabia
| | - Mazen M. Ghaith
- Laboratory Medicine Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Lujain A. Bahubaish
- Clinical Nutrition Department, Diaverum A.B. North Jeddah, Jeddah, Saudi Arabia
| | - Osama A. Kensara
- Clinical Nutrition Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- Medicine Program, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Hussain A. Almasmoum
- Laboratory Medicine Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah F. Aldairi
- Laboratory Medicine Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Anmar A. Khan
- Laboratory Medicine Department, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ahmad A. Alghamdi
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Ghalia Shamlan
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Maha H. Alhussain
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Reham M. Algheshairy
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Saudi Arabia
| | - Abdullah M. AlShahrani
- Department of Basic Medical Sciences, College of Applied Medical Sciences, Khamis Mushayt, King Khalid University, Abha, Saudi Arabia
| | - Maysoun S. Qutob
- Clinical Nutrition and Dietetics Department, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Awfa Y. Alazzeh
- Department of Clinical Nutrition, College of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
| | - Haitham M.H. Qutob
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology - Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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Kurajoh M, Mori K, Miyabe M, Matsufuji S, Kizu A, Tsujimoto Y, Emoto M. Xanthine Oxidoreductase Inhibitor Use Associated With Reduced Risk of Sarcopenia and Severe Sarcopenia in Patients Undergoing Hemodialysis. Front Med (Lausanne) 2022; 9:817578. [PMID: 35198574 PMCID: PMC8859856 DOI: 10.3389/fmed.2022.817578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Xanthine oxidoreductase (XOR) inhibition reduces reactive oxygen species (ROS) production and enhances adenosine triphosphate (ATP) synthesis. We investigated the protective effects of XOR inhibitor treatment on sarcopenia, frequently observed in patients undergoing hemodialysis (HD), in which increased ROS and ATP shortage are known to be involved. Methods This retrospective cross-sectional study included 296 HD patient (203 males, 93 females). Muscle mass, physical performance, and muscle strength were assessed using dual-energy X-ray absorptiometry, five-time chair stand testing, and handgrip strength, respectively. The Asian Working Group for Sarcopenia 2019 criteria were used to define low muscle mass, low physical performance, and low muscle strength, as well as sarcopenia and severe sarcopenia. Results Sarcopenia and severe sarcopenia prevalence rates were 42.2 and 20.9%, respectively. XOR inhibitor users (n = 119) showed a significantly (p < 0.05) lower prevalence of sarcopenia and severe sarcopenia, as well as reduced muscle mass, physical performance, and muscle strength than non-users (n = 177). Multivariate logistic regression analyses also revealed XOR inhibitor use to be significantly associated with low muscle mass [odds ratio (OR), 0.384; 95% confidence interval (CI), 0.183–0.806; p = 0.011] and low physical performance (OR, 0.286; 95% CI, 0.142–0.578; p < 0.001), while significance with low muscle strength was borderline. Furthermore, XOR inhibitor use was significantly associated with sarcopenia (OR, 0.462; 95% CI, 0.226–0.947; p = 0.035) and severe sarcopenia (OR, 0.236; 95% CI, 0.091–0.614; p = 0.003). Conclusions XOR inhibitor use was significantly associated with reduced risk of sarcopenia/severe sarcopenia in HD patients, suggesting that XOR inhibitor treatment has protective effects on sarcopenia in HD patients.
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Affiliation(s)
- Masafumi Kurajoh
- Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Katsuhito Mori
- Department of Nephrology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mizuki Miyabe
- Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.,Division of Internal Medicine, Dialysis Center, Inoue Hospital, Osaka, Japan
| | | | - Akane Kizu
- Division of Internal Medicine, Dialysis Center, Inoue Hospital, Osaka, Japan
| | - Yoshihiro Tsujimoto
- Division of Internal Medicine, Dialysis Center, Inoue Hospital, Osaka, Japan
| | - Masanori Emoto
- Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.,Department of Nephrology, Osaka City University Graduate School of Medicine, Osaka, Japan
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9
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Cha RH, Lee GS. Steady exercise improves hand grip and leg muscle strength in hemodialysis patients. J Exerc Rehabil 2021; 17:435-443. [PMID: 35036393 PMCID: PMC8743601 DOI: 10.12965/jer.2142616.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/21/2021] [Indexed: 11/22/2022] Open
Abstract
Sarcopenia due to chronic inflammation and biochemical disturbances in chronic kidney disease is severer and more prevalent in hemodialysis (HD) patients. We longitudinally evaluated the hand grip strength (HGS) and leg muscle strength (LMS) and evaluated the role of exercise in muscle strength in HD patients. We screened (January, n=127) and followed up (June, n=110 and December 2020, n=104). HGS and LMS at single center by using digital hand and leg dynamometer. HGS (24.2 kg vs. 15.5 kg) and LMS (32.8 kg vs. 22.5 kg) were better in men (P<0.001 and P<0.001, respectively). Older patients (≥60 years) showed decreased LMS than others in women (P=0.01). Patients who performed steady home- or hospital-based exercise showed marginally higher HGS (23.1 kg vs. 19.8 kg, P=0.07) and significantly higher LMS (33.7 kg vs. 25.9 kg, P=0.004). Steady exercise improved LMS throughout the study period (30.3 kg vs. 33.2 kg from Jan to Jun 2020, P=0.004; 30.3 kg vs. 34.2 kg from Jan to Dec 2020, P=0.014). Multiple linear regression analysis proved steady exercise was independently associated with better HGS and LMS. Steady exercise showed greater impact on LMS in male patients with longer HD vintage (≥44 months) and on HGS in younger male patients with shorter HD vintage (<44 months). Steady exercise was an important determinant of muscle strength in HD patients. We need to encourage patients to steadily perform regular home- or group-exercise before sarcopenia develops.
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Affiliation(s)
- Ran-hui Cha
- Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Geum Sil Lee
- Department of Internal Medicine, National Medical Center, Seoul, Korea
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