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Acute exercise during hemodialysis prevents the decrease in natural killer cells in patients with chronic kidney
Maria Isabel Fuhro1, Gilson P Dorneles2, Francini P Andrade3
1Research Center, Methodist University Center IPA, Porto Alegre, Brazil.
International Urology and Nephrology
|November 15, 2017
Summary
Intradialytic exercise may prevent decreases in natural killer (NK) cell subsets during hemodialysis (HD) for chronic kidney disease patients. This exercise did not worsen inflammation or cause muscle damage in the study.
Area of Science:
- Immunology
- Nephrology
- Exercise Physiology
Background:
- Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) often experience immune system dysregulation.
- Natural killer (NK) cells are crucial for immune surveillance and their function can be impaired during HD.
- Intradialytic exercise is being explored as a supportive therapy for CKD patients.
Purpose of the Study:
- To investigate the acute effects of intradialytic exercise on NK cell subsets in CKD patients.
- To assess whether intradialytic exercise impacts systemic inflammation and muscle damage markers during HD.
- To compare the immune response to intradialytic exercise versus a standard HD session.
Main Methods:
- A randomized crossover study involving nine CKD patients undergoing HD.
- Patients completed a 20-minute intradialytic exercise session and a control HD session separated by a 7-day interval.
- Peripheral blood samples were analyzed for NK cell subsets (CD3-CD56bright, CD3-CD56dim), cortisol, CRP, CK, urea, and creatinine levels at multiple time points.
Main Results:
- Hemodialysis alone significantly reduced the frequency of total NK cells and their subsets (p < 0.05).
- Intradialytic exercise did not cause significant alterations in NK cell populations during or after the session (p > 0.05).
- Neither HD nor intradialytic exercise significantly affected CRP or CK levels, but HD increased cortisol concentrations post-session (p = 0.034).
Conclusions:
- Intradialytic exercise shows promise in mitigating the reduction of NK cell subsets observed during HD therapy.
- Moderate-intensity intradialytic exercise appears safe, not exacerbating systemic inflammation or causing muscle damage in CKD patients.
- This suggests intradialytic exercise could be a beneficial intervention for immune support in CKD patients on HD.
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