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Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency. A randomized, controlled trial.
Ann Intern Med. 2001 Dec 04; 135(11):965-76.AIM

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

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Authors+Show Affiliations

Castaneda C
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA. ccastaneda@hnrc.tufts.edu
Gordon PL
No affiliation info available
Uhlin KL
No affiliation info available
Levey AS
No affiliation info available
Kehayias JJ
No affiliation info available
Dwyer JT
No affiliation info available
Fielding RA
No affiliation info available
Roubenoff R
No affiliation info available
Singh MF
No affiliation info available

MeSH

AgedBody WeightCombined Modality TherapyDiet, Protein-RestrictedExercise TherapyFemaleHumansKidney Failure, ChronicLeucineMaleMiddle AgedMuscle Fibers, Fast-TwitchMuscle Fibers, Slow-TwitchMuscle ProteinsMuscle, SkeletalOxidation-ReductionPatient CompliancePotassiumPrealbuminThighWeight Lifting

Pub Type(s)

Clinical Trial
Journal 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

Castaneda, C, et al. "Resistance Training to Counteract the Catabolism of a Low-protein Diet in Patients With Chronic Renal Insufficiency. a Randomized, Controlled Trial." Annals of Internal Medicine, vol. 135, no. 11, 2001, pp. 965-76.
Castaneda C, Gordon PL, Uhlin KL, et al. Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency. A randomized, controlled trial. Ann Intern Med. 2001;135(11):965-76.
Castaneda, C., Gordon, P. L., Uhlin, K. L., Levey, A. S., Kehayias, J. J., Dwyer, J. T., Fielding, R. A., Roubenoff, R., & Singh, M. F. (2001). Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency. A randomized, controlled trial. Annals of Internal Medicine, 135(11), 965-76.
Castaneda C, et al. Resistance Training to Counteract the Catabolism of a Low-protein Diet in Patients With Chronic Renal Insufficiency. a Randomized, Controlled Trial. Ann Intern Med. 2001 Dec 4;135(11):965-76. PubMed PMID: 11730397.
* 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.acpjournals.org/doi/10.7326/0003-4819-135-11-200112040-00008?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -