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Exercise improves albumin fractional synthetic rate in chronic hemodialysis patients

Abstract

Objective:

To determine whether exercise augments the improvements in fractional synthetic rate (FSR) of albumin observed with nutrition alone.

Design:

Randomized crossover study. Each patient randomly participated in two protein metabolism kinetic studies using primed-constant infusion of (13C) leucine 2 h before, during and 2 h after hemodialysis. Plasma enrichments of (13C) leucine and (13C) ketoisocaproate were examined to determine the FSR of albumin.

Setting:

General Clinical Research Center at Vanderbilt University Medical Center.

Subjects:

Five chronic hemodialysis (CHD) patients.

Interventions:

Intra-dialytic parenteral nutrition (IDPN) with or without exercise.

Results:

Exercise performance during hemodialysis significantly improves the FSR of albumin beyond what is observed with IDPN alone (26.2±3.1% per day versus 17.7±1.9% per day, P<0.05).

Conclusion:

Exercise improves albumin fractional synthetic rate beyond what is observed with IDPN alone in the acute setting in CHD patients.

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References

  • Ahlman B, Charlton M, Fu A, Berg C, O'Brien P, Nair KS (2001). Insulin's effect on synthesis rates of liver proteins. A swine model comparing various precursors of protein synthesis. Diabetes 50, 947–954.

    Article  CAS  Google Scholar 

  • Barazzoni R, Meek SE, Ekberg K, Wahren J, Nair KS (1999). Arterial KIC as marker of liver and muscle intracellular leucine pools in healthy and type 1 diabetic humans. Am J Physiol 277, E238–E244.

    CAS  PubMed  Google Scholar 

  • Danielski M, Ikizler TA, McMonagle E, Kane JC, Pupim L, Morrow J et al. (2003). Linkage of hypoalbuminemia, inflammation, and oxidative stress in patients receiving maintenance hemodialysis therapy. Am J Kidney Dis 42, 286–294.

    Article  CAS  Google Scholar 

  • De Feo P, Gaisano MG, Haymond MW (1991). Differential effects of insulin deficiency on albumin and fibrinogen synthesis in humans. J Clin Invest 88, 833–840.

    Article  CAS  Google Scholar 

  • De Feo P, Horber FF, Haymond MW (1992). Meal stimulation of albumin synthesis: a significant contributor to whole body protein synthesis in humans. Am J Physiol 263, E794–E799.

    Article  CAS  Google Scholar 

  • Ikizler TA, Pupim LB, Brouillette JR, Levenhagen DK, Farmer K, Hakim RM et al. (2002). Hemodialysis stimulates muscle and whole body protein loss and alters substrate oxidation. Am J Physiol Endocrinol Metab 282, E107–E116.

    Article  CAS  Google Scholar 

  • Jeejeebhoy KN (1998). Nutritional assessment. Gastroenterol Clin N Am 27, 347–369.

    Article  CAS  Google Scholar 

  • Klein S (1990). The myth of serum albumin as a measure of nutritional status. Gastroenterology 99, 1845–1846.

    Article  CAS  Google Scholar 

  • Pupim LB, Flakoll PJ, Brouillette JR, Levenhagen DK, Hakim RM, Ikizler TA (2002). Intradialytic parenteral nutrition improves protein and energy homeostasis in chronic hemodialysis patients. J Clin Invest 110, 483–492.

    Article  CAS  Google Scholar 

  • Pupim LB, Flakoll PJ, Ikizler TA (2004a). Nutritional supplementation acutely increases albumin fractional synthetic rate in chronic hemodialysis patients. J Am Soc Nephrol 15, 1920–1926.

    Article  CAS  Google Scholar 

  • Pupim LB, Flakoll PJ, Levenhagen DK, Ikizler TA (2004b). Exercise augments the acute anabolic effects of intradialytic parenteral nutrition in chronic hemodialysis patients. Am J Physiol Endocrinol Metab 286, E589–E597.

    Article  CAS  Google Scholar 

  • USRDS (1999). Excerpts from United States renal data system 1999 annual data report. Am J Kidney Dis 34, S1–S176.

  • Wasserman DH, Geer RJ, Rice DE, Bracy D, Flakoll PJ, Brown LL et al. (1991). Interaction of exercise and insulin action in humans. Am J Physiol 260, E37–E45.

    CAS  PubMed  Google Scholar 

  • Wasserman K (1999). Principles of Exercise Testing & Interpretation: Including Pathophysiology and Clinical Applications. Lippincott Williams & Wilkins, Philadelphia, PA.

    Google Scholar 

Download references

Acknowledgements

The present work is partly supported by the National Institutes of Health Grants R01-DK45604, K24-DK62849 and DK-20593 from the National Institute of Diabetes, Digestive and Kidney Diseases, M01 RR-00095 from the National Center for Research Resources and Satellite Health Norman Coplon Extramural Grant Program. The excellent technical assistance of D Levenhagen, S Vaughan, J Harvell, M Zheng, P Egbert, F Moustofi and the nursing staff on the GCRC is appreciated. LB Pupim is an employee of Amgen Inc since August of 2005.

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Correspondence to T A Ikizler.

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Pupim, L., Flakoll, P. & Ikizler, T. Exercise improves albumin fractional synthetic rate in chronic hemodialysis patients. Eur J Clin Nutr 61, 686–689 (2007). https://doi.org/10.1038/sj.ejcn.1602578

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602578

Keywords

  • albumin
  • catabolism
  • hemodialysis
  • synthesis
  • exercise

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