Effects of Long-Term Intra-Dialytic Oral Nutrition and Exercise on Muscle Protein Homeostasis and Markers of Mitochondrial Content in Patients on Hemodialysis.

Effects of Long-Term Intra-Dialytic Oral Nutrition and Exercise on Muscle Protein Homeostasis and Markers of Mitochondrial Content in Patients on Hemodialysis. Am J Physiol Renal Physiol. 2020 Sep 28;: Authors: Gamboa JL, Deger SM, Perkins BW, Mambungu C, Sha F, Mason OJ, Stewart TG, Ikizler TA Abstract Patients with end-stage kidney disease (ESKD) on maintenance hemodialysis (MHD) commonly develop protein-energy wasting (PEW), a syndrome characterized by nutritional and metabolic abnormalities. Nutritional supplementation and exercise are recommended to prevent PEW. In a six-month prospective randomized, open-label, clinical trial, we reported that the combination of resistance exercise and nutritional supplementation does not have an additive effect on lean body mass measured by DEXA. In order to provide more mechanistic data, we performed a secondary analysis where we hypothesized that the combination of nutritional supplementation and resistance exercise would have additive effects on muscle protein accretion by stable isotope protein kinetic studies, muscle mass by MRI, and mitochondrial content markers in muscle. We found that six months of nutritional supplementation during hemodialysis increased muscle protein net balance [baseline: 2.5 (-17.8, 13.0) vs. 6-month: 43.7 (13.0, 98.5) µg/100ml/min, median (IQR), p=0.04], and mid-thigh fat area [baseline: 162.3 (104.7, 226.6) vs. 6-month: 181.9 (126.3, 279.2) cm2, median (IQR), p...
Source: American Journal of Physiology. Renal Physiology - Category: Physiology Authors: Tags: Am J Physiol Renal Physiol Source Type: research