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Exercise augments the acute anabolic effects of intradialytic parenteral nutrition in chronic hemodialysis patients.
Am J Physiol Endocrinol Metab. 2004 Apr; 286(4):E589-97.AJ

Abstract

Decreased dietary protein intake and hemodialysis (HD)-associated protein catabolism are among several factors that predispose chronic hemodialysis (CHD) patients to uremic malnutrition and associated muscle wasting. Intradialytic parenteral nutrition (IDPN) acutely reverses the net negative whole body and forearm muscle protein balances observed during the HD procedure. Exercise has been shown to improve muscle protein homeostasis, especially if performed with adequately available intramuscular amino acids. We hypothesized that exercise performance would provide additive anabolic effects to the beneficial effects of IDPN. We studied six CHD patients at two separate HD sessions: 1) IDPN administration only and 2) IDPN + exercise. Patients were studied 2 h before, during, and 2 h after an HD session by use of a primed constant infusion of l-[1-(13)C]leucine and l-[ring-(2)H(5)] phenylalanine. Exercise combined with IDPN promoted additive twofold increases in forearm muscle essential amino acid uptake (455 +/- 105 vs. 229 +/- 38 nmol.100 ml(-1).min(-1), P < 0.05) and net muscle protein accretion (125 +/- 37 vs. 56 +/- 30 microg.100 ml(-1).min(-1), P < 0.05) during HD compared with IDPN alone. Measurements of whole body protein homeostasis and energy expenditure were not altered by exercise treatment. In conclusion, exercise in the presence of adequate nutritional supplementation has potential as a therapeutic intervention to blunt the loss of muscle mass in CHD patients.

Authors+Show Affiliations

Division of Nephrology, S-3223 MCN, Vanderbilt University Medical Center, 1161 21st Avenue South & Garland, Nashville, TN 37232-2372, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14678952

Citation

Pupim, Lara B., et al. "Exercise Augments the Acute Anabolic Effects of Intradialytic Parenteral Nutrition in Chronic Hemodialysis Patients." American Journal of Physiology. Endocrinology and Metabolism, vol. 286, no. 4, 2004, pp. E589-97.
Pupim LB, Flakoll PJ, Levenhagen DK, et al. Exercise augments the acute anabolic effects of intradialytic parenteral nutrition in chronic hemodialysis patients. Am J Physiol Endocrinol Metab. 2004;286(4):E589-97.
Pupim, L. B., Flakoll, P. J., Levenhagen, D. K., & Ikizler, T. A. (2004). Exercise augments the acute anabolic effects of intradialytic parenteral nutrition in chronic hemodialysis patients. American Journal of Physiology. Endocrinology and Metabolism, 286(4), E589-97.
Pupim LB, et al. Exercise Augments the Acute Anabolic Effects of Intradialytic Parenteral Nutrition in Chronic Hemodialysis Patients. Am J Physiol Endocrinol Metab. 2004;286(4):E589-97. PubMed PMID: 14678952.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exercise augments the acute anabolic effects of intradialytic parenteral nutrition in chronic hemodialysis patients. AU - Pupim,Lara B, AU - Flakoll,Paul J, AU - Levenhagen,Deanna K, AU - Ikizler,T Alp, Y1 - 2003/12/16/ PY - 2003/12/18/pubmed PY - 2004/4/16/medline PY - 2003/12/18/entrez SP - E589 EP - 97 JF - American journal of physiology. Endocrinology and metabolism JO - Am. J. Physiol. Endocrinol. Metab. VL - 286 IS - 4 N2 - Decreased dietary protein intake and hemodialysis (HD)-associated protein catabolism are among several factors that predispose chronic hemodialysis (CHD) patients to uremic malnutrition and associated muscle wasting. Intradialytic parenteral nutrition (IDPN) acutely reverses the net negative whole body and forearm muscle protein balances observed during the HD procedure. Exercise has been shown to improve muscle protein homeostasis, especially if performed with adequately available intramuscular amino acids. We hypothesized that exercise performance would provide additive anabolic effects to the beneficial effects of IDPN. We studied six CHD patients at two separate HD sessions: 1) IDPN administration only and 2) IDPN + exercise. Patients were studied 2 h before, during, and 2 h after an HD session by use of a primed constant infusion of l-[1-(13)C]leucine and l-[ring-(2)H(5)] phenylalanine. Exercise combined with IDPN promoted additive twofold increases in forearm muscle essential amino acid uptake (455 +/- 105 vs. 229 +/- 38 nmol.100 ml(-1).min(-1), P < 0.05) and net muscle protein accretion (125 +/- 37 vs. 56 +/- 30 microg.100 ml(-1).min(-1), P < 0.05) during HD compared with IDPN alone. Measurements of whole body protein homeostasis and energy expenditure were not altered by exercise treatment. In conclusion, exercise in the presence of adequate nutritional supplementation has potential as a therapeutic intervention to blunt the loss of muscle mass in CHD patients. SN - 0193-1849 UR - https://www.unboundmedicine.com/medline/citation/14678952/Exercise_augments_the_acute_anabolic_effects_of_intradialytic_parenteral_nutrition_in_chronic_hemodialysis_patients_ L2 - http://www.physiology.org/doi/full/10.1152/ajpendo.00384.2003?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -