Metabolic and hormonal responses to chronic blood-flow restricted resistance training in chronic kidney disease: a randomized trial

• Published in: Applied Physiology, Nutrition, and Metabolism Nutrition, and Metabolism, 2022, Vol.47 (2), p.183
• Main Authors: Deus, Lysleine Alves de, Correa, Hugo de Luca, Neves, Rodrigo Vanerson Passos, Reis, Andrea Lucena, Honorato, Fernando Sousa, Araujo, Thais Branquinho de, Souza, Michel Kendy, Haro, Anderson Sola, Silva, Victor Lopes, Barbosa, Jessica Mycaelle da Silva, Padula, Isabela Akaishi, Andrade, Rosangela Vieira, Simoes, Herbert Gustavo, Prestes, Jonato, Stone, Whitley J, Melo, Gislane Ferreira, Rosa, Thiago Santos
• Format: Report
• Language: English
• Subjects: Blood flow; Care and treatment; Chronic kidney failure; Control; Glomerular filtration rate; Glucose metabolism; Health aspects; Methods; Physiological aspects; Strengthening exercises
• ISSN: 1715-5312
• DOI: 10.1139/apnm-2021-0409

Maintenance of glycemic and lipemic homeostasis can limit the progression of diabetic kidney disease. Resistance training (RT) is effective in controlling glycemia and lipemia in kidney disease; however, the effect of RT with blood flow restriction (RT+BFR) on these metabolic factors has not been investigated. We aimed to verify if chronic (6 months) RT and RT+BFR performed by patients with stage-2 chronic kidney disease (CKD) improves their glycemic homeostasis and immunometabolic profiles. Patients with CKD under conservative treatment (n = 105 (33 females)) from both sexes were randomized into control (n = 35 (11 females); age 57.6 [+ or -] 5.2 years), RT (n = 35 (12 females); age 58.0 [+ or -] 6.2 years), and RT+BFR (n = 35 (10 females); 58.0 [+ or -] 6.4 years) groups. Chronic RT or RT+BFR (6 months) was performed 3 times per week on non-consecutive days with training loading adjusted every 2 months, RT 50%-60%-70% of 1RM, and RT+BFR 30%-40%+50% of 1RM and fixed repetition number. Renal function was estimated with the glomerular filtration rate and serum albumin level. Metabolic, hormonal, and inflammatory assessments were analyzed from blood samples. Six months of RT and RT+BFR were similarly effective in improving glucose homeostasis and hormone mediators of glucose uptake (e.g., irisin, adiponectin, and sirtuin-1), decreasing pro-inflammatory and fibrotic proteins, and attenuating the progression of estimated glomerular filtration rate. Thus, RT+BFR can be considered an additional exercise modality to be included in the treatment of patients with stage 2 chronic kidney disease. Trial registration number: U1111-1237-8231. URL: Novelty: * Glycemic regulation induced by resistance training prevents the progression of CKD. * Chronic RT and RT+BFR promote similar changes in glycemic regulation. * RT and RT+BFR can be considered as non-pharmacological tools for the treatment of CKD. Key words: kidney disease, resistance training, glucose, blood flow restriction, metabolic homeostasis, hypoxia. Le maintien de l'homeostasie glycemique et lipemique peut limiter la progression de l'insuffisance renale diabetique. L'entrainement en resistance (>) est efficace pour controler la glycemie et la lipemie dans les maladies renales; toutefois, l'effet de RT avec restriction du flux sanguin (>) sur ces facteurs metaboliques n'a pas ete examine. L'objectif de cette recherche etait de verifier si le RT et le RT+BFR a long terme (six mois) realises par