Journal
NEPHROLOGY DIALYSIS TRANSPLANTATION
Volume 23, Issue 4, Pages 1362-1369Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ndt/gfm773
Keywords
haemodialysis; metabolism; protein supplementation; resistance exercise
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Funding
- NCRR NIH HHS [M01-RR00095] Funding Source: Medline
- NIDDK NIH HHS [DK-20593, R01-DK45604, K24-DK62849] Funding Source: Medline
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Background. An intriguing strategy to further enhance the anabolic effects of nutritional supplementation is to combine the administration of nutrients with resistance exercise. We hypothesized that the addition of resistance exercise to oral nutrition supplementation would lead to further increases in skeletal muscle protein accretion when compared to nutritional supplementation alone in chronic haemodialysis (CHD) patients. Methods. We performed stable isotope protein kinetic studies in eight CHD patients during two separate settings: with oral nutritional supplementation alone (PO) and oral nutritional supplementation combined with a single bout of resistance exercise (PO + EX). Metabolic assessment was performed before, during and after haemodialysis. Both interventions resulted in robust protein anabolic response. Results. There were no differences in metabolic hormones, plasma amino acid and whole-body protein balance between the interventions. During the post-HD phase, PO + EX retained a positive total amino acid (TAA) balance (primarily due to essential amino acid) while PO returned to a negative TAA balance although this difference did not reach statistical significance (78 +/- 109 versus 128 +/- 72 nmol/100 ml/min, respectively; P = 0.69). In the post-HD phase, PO EX had significantly higher net muscle protein balance when compared to PO (19 +/- 16 versus -24 +/- 10 g100 ml/min, respectively; P = 0.036) We conclude that a single bout of resistance exercise augments the protein anabolic effects of oral intradialytic nutritional supplementation when examining skeletal muscle protein turnover.
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