Intradialytic Cycling Does Not Exacerbate Microparticles or Circulating Markers of Systemic Inflammation in Haemodialysis Patients

Overview

Journal Eur J Appl Physiol

Specialty Physiology

Date 2021 Dec 2

PMID 34854982

Citations 2

Authors

Patrick J Highton

Daniel S March

Darren R Churchward

Charlotte E Grantham

Hannah M L Young

Matthew P M Graham-Brown

Seila Estruel

Naomi Martin

Nigel J Brunskill

Alice C Smith

James O Burton

Nicolette C Bishop

Affiliations

Soon will be listed here.

Abstract

Purpose: Patients receiving haemodialysis (HD) display elevated circulating microparticle (MP) concentration, tissue factor (TF) expression and markers of systemic inflammation, though regular intradialytic cycling (IDC) may have a therapeutic effect. This study investigated the impact of regular, moderate-intensity IDC on circulating MPs and inflammatory markers in unit-based HD patients.

Methods: Patients were cluster-randomised to intervention (n = 20, age: 51.4 ± 18.1 years, body mass: 77.6 ± 18.3 kg, mean ± SD) or no-exercise control (n = 20, 56.8 ± 14.0 years, 80.5 ± 26.5 kg). Intervention participants completed 30 min of moderate intensity (rating of perceived exertion [RPE] of 12-14) IDC, thrice weekly for 6 months. Pre-dialysis venous blood samples were obtained at 0, 3 and 6 months. Circulating MP phenotypes, cytokines, chemokine and MP TF expression were quantified using flow cytometry and cytometric bead array assays.

Results: Despite high exercise compliance (82%), no IDC-dependent effects were observed for any MP, cytokine or chemokine measure (p ≥ 0.051, η ≤ 0.399) other than TNF-α (p = 0.001, η = 0.186), though no significance was revealed upon post hoc analysis.

Conclusion: Six months of regular, moderate-intensity IDC had no effect on MPs, cytokines or chemokines. This suggests that the exercise did not exacerbate thrombotic or inflammatory status, though further functional assays are required to confirm this.

Trial Registration: ISRCTN1129707, prospectively registered on 05/03/2015.

Citing Articles

Effects of Exercise on Inflammatory Markers in Individuals with Chronic Kidney Disease: A Systematic Review and Meta-Analysis.

Baiao V, Cunha V, Duarte M, Andrade F, Ferreira A, Nobrega O Metabolites. 2023; 13(7).

PMID: 37512502 PMC: 10385645. DOI: 10.3390/metabo13070795.

Effect of Exercise on Inflammation in Hemodialysis Patients: A Systematic Review.

Melendez Oliva E, Villafane J, Alonso Perez J, Alonso Sal A, Molinero Carlier G, Quevedo Garcia A J Pers Med. 2022; 12(7).

PMID: 35887685 PMC: 9322638. DOI: 10.3390/jpm12071188.

References

Martin N, Smith A, Dungey M, Young H, Burton J, Bishop N . Exercise during hemodialysis does not affect the phenotype or prothrombotic nature of microparticles but alters their proinflammatory function. Physiol Rep. 2018; 6(19):e13825. PMC: 6174123. DOI: 10.14814/phy2.13825. View

Babbitt D, Diaz K, Feairheller D, Sturgeon K, Perkins A, Veerabhadrappa P . Endothelial activation microparticles and inflammation status improve with exercise training in african americans. Int J Hypertens. 2013; 2013:538017. PMC: 3652180. DOI: 10.1155/2013/538017. View

Stenvinkel P, Ketteler M, Johnson R, Lindholm B, Pecoits-Filho R, Riella M . IL-10, IL-6, and TNF-alpha: central factors in the altered cytokine network of uremia--the good, the bad, and the ugly. Kidney Int. 2005; 67(4):1216-33. DOI: 10.1111/j.1523-1755.2005.00200.x. View

Moser B, Roth G, Brunner M, Lilaj T, Deicher R, Wolner E . Aberrant T cell activation and heightened apoptotic turnover in end-stage renal failure patients: a comparative evaluation between non-dialysis, haemodialysis, and peritoneal dialysis. Biochem Biophys Res Commun. 2003; 308(3):581-5. DOI: 10.1016/s0006-291x(03)01389-5. View

Toussaint N, Polkinghorne K, Kerr P . Impact of intradialytic exercise on arterial compliance and B-type natriuretic peptide levels in hemodialysis patients. Hemodial Int. 2008; 12(2):254-63. DOI: 10.1111/j.1542-4758.2008.00262.x. View

Heine G, Ortiz A, Massy Z, Lindholm B, Wiecek A, Martinez-Castelao A . Monocyte subpopulations and cardiovascular risk in chronic kidney disease. Nat Rev Nephrol. 2012; 8(6):362-9. DOI: 10.1038/nrneph.2012.41. View

Hashmi S, Zeng Q . Role of interleukin-17 and interleukin-17-induced cytokines interleukin-6 and interleukin-8 in unstable coronary artery disease. Coron Artery Dis. 2006; 17(8):699-706. DOI: 10.1097/01.mca.0000236288.94553.b4. View

Amabile N, Guerin A, Tedgui A, Boulanger C, London G . Predictive value of circulating endothelial microparticles for cardiovascular mortality in end-stage renal failure: a pilot study. Nephrol Dial Transplant. 2011; 27(5):1873-80. DOI: 10.1093/ndt/gfr573. View

McIntyre C, Burton J, Selby N, Leccisotti L, Korsheed S, Baker C . Hemodialysis-induced cardiac dysfunction is associated with an acute reduction in global and segmental myocardial blood flow. Clin J Am Soc Nephrol. 2007; 3(1):19-26. PMC: 2390980. DOI: 10.2215/CJN.03170707. View

10.

Graham-Brown M, March D, Young R, Highton P, Young H, Churchward D . A randomized controlled trial to investigate the effects of intra-dialytic cycling on left ventricular mass. Kidney Int. 2021; 99(6):1478-1486. DOI: 10.1016/j.kint.2021.02.027. View

11.

Gleeson M, Bishop N, Stensel D, Lindley M, Mastana S, Nimmo M . The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol. 2011; 11(9):607-15. DOI: 10.1038/nri3041. View

12.

van der Pol E, Coumans F, Grootemaat A, Gardiner C, Sargent I, Harrison P . Particle size distribution of exosomes and microvesicles determined by transmission electron microscopy, flow cytometry, nanoparticle tracking analysis, and resistive pulse sensing. J Thromb Haemost. 2014; 12(7):1182-92. DOI: 10.1111/jth.12602. View

13.

Berg A, Scherer P . Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005; 96(9):939-49. DOI: 10.1161/01.RES.0000163635.62927.34. View

14.

Papayianni A, Alexopoulos E, Giamalis P, Gionanlis L, Belechri A, Koukoudis P . Circulating levels of ICAM-1, VCAM-1, and MCP-1 are increased in haemodialysis patients: association with inflammation, dyslipidaemia, and vascular events. Nephrol Dial Transplant. 2002; 17(3):435-41. DOI: 10.1093/ndt/17.3.435. View

15.

Golebiowski T, Kusztal M, Weyde W, Dziubek W, Wozniewski M, Madziarska K . A program of physical rehabilitation during hemodialysis sessions improves the fitness of dialysis patients. Kidney Blood Press Res. 2012; 35(4):290-6. DOI: 10.1159/000335411. View

16.

Kusano K, Nakamura K, Kusano H, Nishii N, Banba K, Ikeda T . Significance of the level of monocyte chemoattractant protein-1 in human atherosclerosis. Circ J. 2004; 68(7):671-6. DOI: 10.1253/circj.68.671. View

17.

Peres A, Perotto D, Dorneles G, Fuhro M, Monteiro M . Effects of intradialytic exercise on systemic cytokine in patients with chronic kidney disease. Ren Fail. 2015; 37(9):1430-4. DOI: 10.3109/0886022X.2015.1074473. View

18.

Piccin A, Murphy W, Smith O . Circulating microparticles: pathophysiology and clinical implications. Blood Rev. 2006; 21(3):157-71. DOI: 10.1016/j.blre.2006.09.001. View

19.

Delgado C, Johansen K . Barriers to exercise participation among dialysis patients. Nephrol Dial Transplant. 2011; 27(3):1152-7. PMC: 3289894. DOI: 10.1093/ndt/gfr404. View

20.

Troseid M, Lappegard K, Claudi T, Damas J, Morkrid L, Brendberg R . Exercise reduces plasma levels of the chemokines MCP-1 and IL-8 in subjects with the metabolic syndrome. Eur Heart J. 2004; 25(4):349-55. DOI: 10.1016/j.ehj.2003.12.006. View