Metabolic effects of exercise training in hemodialysis patients

The effects of 9 +/- 6 months of exercise training on lipid and carbohydrate metabolism were studied in six hemodialysis patients. Training lowered triglyceride levels 39 +/- 25% (P less than 0.02) and increased plasma high-density lipoprotein cholesterol levels 23 +/- 22% (before, 26 +/- 5 mg/dl; after, 31 +/- 8 mg/dl; P less than 0.05). There was a 23% improvement in glucose tolerance (P less than 0.01) and a 40% reduction in hyperinsulinism (P less than 0.01) with no significant changes in body weight or diet. There was a 25 +/- 8% increase in hematocrits (before, 22 +/- 2%; after, 27 +/- 2%, P less than 0.01) and a 29 +/- 2% rise in hemoglobin concentrations (before, 7.0 +/- 0.8 g/dl; after, 9.0 +/- 0.6 g/dl, P less than 0.04) in five patients. In addition, during training antihypertensive medications could be reduced in three patients with maintenance of normal blood pressure. The improvements in lipid and carbohydrate metabolism diminished when two patients stopped training. These results suggest that physical training can improve some of the metabolic abnormalities observed in hemodialysis patients and could be important as a therapeutic modality.