Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency. A randomized, controlled trial.
Abstract
BACKGROUND
Chronic renal insufficiency leads to muscle wasting, which may be exacerbated by low-protein diets prescribed to delay disease progression. Resistance training increases protein utilization and muscle mass.OBJECTIVE
To determine the efficacy of resistance training in improving protein utilization and muscle mass in patients with chronic renal insufficiency treated with a low-protein diet.DESIGN
Randomized, controlled trial.SETTING
Tufts University, Boston, Massachusetts.PATIENTS
26 older patients with moderate renal insufficiency (17 men, 9 women) who had achieved stabilization on a low-protein diet.INTERVENTION
During a run-in period of 2 to 8 weeks, patients were instructed and their adherence to the low-protein diet (0.6 g/kg of body weight per day) was evaluated. They were randomly assigned to a low-protein diet plus resistance training (n = 14) or a low-protein diet alone (n = 12) for 12 weeks.MEASUREMENTS
Total body potassium, mid-thigh muscle area, type I and II muscle-fiber cross-sectional area, and protein turnover.RESULTS
Mean protein intake was 0.64 +/- 0.07 g/kg per day after stabilization. Total body potassium and type I and II muscle-fiber cross-sectional areas increased in patients who performed resistance training by a mean (+/-SD) of 4% +/- 8%, 24% +/- 31%, and 22% +/- 29%, respectively, compared with those who did not. Leucine oxidation and serum prealbumin levels also improved significantly. Patients assigned to resistance training maintained body weight compared with those who were not. Improvement in muscle strength was significantly greater with resistance training (32% +/- 14%) than without (-13% +/- 20%) (P < 0.001).CONCLUSION
By improving muscle mass, nutritional status, and function, resistance training seems to be effective against the catabolism of a low-protein diet and uremia in patients with renal failure.Links
Authors+Show Affiliations
,Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA. ccastaneda@hnrc.tufts.edu
, , , , , , ,Source
Annals of internal medicine 135:11 2001 Dec 04 pg 965-76
MeSH
AgedBody Weight
Combined Modality Therapy
Diet, Protein-Restricted
Exercise Therapy
Female
Humans
Kidney Failure, Chronic
Leucine
Male
Middle Aged
Muscle Fibers, Fast-Twitch
Muscle Fibers, Slow-Twitch
Muscle Proteins
Muscle, Skeletal
Oxidation-Reduction
Patient Compliance
Potassium
Prealbumin
Thigh
Weight Lifting
Pub Type(s)
Clinical TrialJournal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.
Language
eng
PubMed ID
11730397
Citation
* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency. A randomized, controlled trial.
AU - Castaneda,C,
AU - Gordon,P L,
AU - Uhlin,K L,
AU - Levey,A S,
AU - Kehayias,J J,
AU - Dwyer,J T,
AU - Fielding,R A,
AU - Roubenoff,R,
AU - Singh,M F,
PY - 2001/12/4/pubmed
PY - 2002/1/5/medline
PY - 2001/12/4/entrez
SP - 965
EP - 76
JF - Annals of internal medicine
JO - Ann. Intern. Med.
VL - 135
IS - 11
N2 - BACKGROUND: Chronic renal insufficiency leads to muscle wasting, which may be exacerbated by low-protein diets prescribed to delay disease progression. Resistance training increases protein utilization and muscle mass. OBJECTIVE: To determine the efficacy of resistance training in improving protein utilization and muscle mass in patients with chronic renal insufficiency treated with a low-protein diet. DESIGN: Randomized, controlled trial. SETTING: Tufts University, Boston, Massachusetts. PATIENTS: 26 older patients with moderate renal insufficiency (17 men, 9 women) who had achieved stabilization on a low-protein diet. INTERVENTION: During a run-in period of 2 to 8 weeks, patients were instructed and their adherence to the low-protein diet (0.6 g/kg of body weight per day) was evaluated. They were randomly assigned to a low-protein diet plus resistance training (n = 14) or a low-protein diet alone (n = 12) for 12 weeks. MEASUREMENTS: Total body potassium, mid-thigh muscle area, type I and II muscle-fiber cross-sectional area, and protein turnover. RESULTS: Mean protein intake was 0.64 +/- 0.07 g/kg per day after stabilization. Total body potassium and type I and II muscle-fiber cross-sectional areas increased in patients who performed resistance training by a mean (+/-SD) of 4% +/- 8%, 24% +/- 31%, and 22% +/- 29%, respectively, compared with those who did not. Leucine oxidation and serum prealbumin levels also improved significantly. Patients assigned to resistance training maintained body weight compared with those who were not. Improvement in muscle strength was significantly greater with resistance training (32% +/- 14%) than without (-13% +/- 20%) (P < 0.001). CONCLUSION: By improving muscle mass, nutritional status, and function, resistance training seems to be effective against the catabolism of a low-protein diet and uremia in patients with renal failure.
SN - 0003-4819
UR - https://www.unboundmedicine.com/medline/citation/11730397/full_citation
L2 - https://www.annals.org/article.aspx?volume=135&issue=11&page=965
DB - PRIME
DP - Unbound Medicine
ER -