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. Epub 2015 Aug 14.

Abstract

Background: Immunological dysfunctions and a pro-inflammatory environment are associated with higher risk of cardiovascular diseases in chronic kidney disease (CKD). Physical exercise can be an important anti-inflammatory strategy, but the effects in CKD remain poorly investigated.

Objective: Evaluate the acute inflammatory response to intradialytic exercise in the peripheral blood of individuals with CKD.

Methods: Nine patients, of both genders, with CKD and allocated in the ambulatory of hemodialysis of Hospital Ernesto Dornelles (Brazil), performed two sessions of hemodialysis (HD) in random form: aerobic intradialytic exercise sessions (EX, 20 min of moderate exercise in cycle-ergometer) and a control hemodialysis session (CON). Peripheral blood collection was made at the baseline, during and immediately after HD to evaluate the cytokine profile: interleukin-6, interleukin-10 (IL-10), interleukin-17a (IL-17a), interferon-gamma (INF-γ) and tumoral necrosis factor-alpha (TNF-α).

Results: INF-γ decreased during HD when compared with the pre moment in both sessions, while an increase in post HD was only found in the CON session. IL-17 was higher in post when compared with during HD in both sessions. In addition to the time effect, IL-10 presented a time × group interaction and the relative changes were significantly higher in EX when compared with the CON session. The relative changes in TNF-α tended to be higher in CON when compared with EX immediately post HD session.

Conclusions: These data indicate that 20 min of intradialytic exercise have modest effect in systemic inflammation. However, the significant increase in IL-10 may indicate an immunoregulatory effect of physical exercise.

Keywords: Chronic kidney disease; hemodialysis; inflammation; peripheral blood; physical exercise.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Brazil
  • Cytokines / blood*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Inflammation / blood*
  • Interferon-gamma / blood
  • Interleukin-10 / blood
  • Interleukin-17 / blood
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / therapy*
  • Tumor Necrosis Factor-alpha / blood

Substances

  • Cytokines
  • IFNG protein, human
  • IL10 protein, human
  • IL17A protein, human
  • IL6 protein, human
  • Interleukin-17
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Interferon-gamma