To determine whether exercise augments the improvements in fractional synthetic rate (FSR) of albumin observed with nutrition alone.
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.
General Clinical Research Center at Vanderbilt University Medical Center.
Five chronic hemodialysis (CHD) patients.
Intra-dialytic parenteral nutrition (IDPN) with or without exercise.
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).
Exercise improves albumin fractional synthetic rate beyond what is observed with IDPN alone in the acute setting in CHD patients.
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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.
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.
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.
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.
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.
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.
Jeejeebhoy KN (1998). Nutritional assessment. Gastroenterol Clin N Am 27, 347–369.
Klein S (1990). The myth of serum albumin as a measure of nutritional status. Gastroenterology 99, 1845–1846.
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.
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.
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.
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.
Wasserman K (1999). Principles of Exercise Testing & Interpretation: Including Pathophysiology and Clinical Applications. Lippincott Williams & Wilkins, Philadelphia, PA.
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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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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