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Combining intra-dialytic exercise and nutritional supplementation in malnourished older haemodialysis patients: Towards better quality of life and autonomy.
Nephrology (Carlton) 2016; 21(9):785-90N

Abstract

Protein-energy wasting (PEW), defined as a loss of body protein mass and fuel reserves, is a powerful predictor of adverse outcomes in haemodialysis (HD) patients. Robust arguments suggest that intra-dialytic exercise, combined with oral/parenteral nutrition, enhances the effect of nutritional interventions in HD patients. This pilot randomized controlled trial investigated the feasibility and the effects of a 6 month intra-dialytic cycling program combined to a nutritional support on PEW, physical functioning (gait, balance, muscle strength) and quality of life (QoL) in older HD patients (mean age 69.7 ± 14.2 years).Twenty-one patients fulfilling diagnostic criteria of PEW were randomly assigned to Nutrition-Exercise group (GN-Ex , n = 10) or Nutrition group (GN , n = 11). Both groups received nutritional supplements in order to reach recommended protein and energy intake goals. In addition GN-Ex completed a cycling program. No significant difference between groups was found in the number of patients having reached remission of PEW. Likewise, no change was observed in serum-albumin, -prealbumin, C-reactive protein, body mass index, lean- and fat-tissue index, or quadriceps force. Interestingly, we found positive effects of exercise on physical function and QoL for the GN-Ex , as evidenced by a significant improvement in the 6-min walk test (+22%), the absence of decline in balance (unlike the GN), and a noteworthy increase in QoL (+53%). Combining intra-dialytic exercise and nutrition in HD patients is feasible, and well accepted, improves physical function and QoL but it appears not to have the potential to reverse PEW.

Authors+Show Affiliations

Dialysis Unit Laënnec, ECHO Association, Nantes, France.Laboratory MIP (UPRES-EA4334), University of Nantes, France.Dialysis Unit Laënnec, ECHO Association, Nantes, France.Dialysis Unit Confluent, ECHO Association, Nantes, France.Biometrics, CHU Nantes, Nantes, France.Dialysis Unit Laënnec, ECHO Association, Nantes, France.Dialysis Unit Laënnec, ECHO Association, Nantes, France.Dialysis Unit Confluent, ECHO Association, Nantes, France.Dialysis Unit Confluent, ECHO Association, Nantes, France.Laboratory MIP (UPRES-EA4334), University of Nantes, France.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26890997

Citation

Hristea, Dan, et al. "Combining Intra-dialytic Exercise and Nutritional Supplementation in Malnourished Older Haemodialysis Patients: Towards Better Quality of Life and Autonomy." Nephrology (Carlton, Vic.), vol. 21, no. 9, 2016, pp. 785-90.
Hristea D, Deschamps T, Paris A, et al. Combining intra-dialytic exercise and nutritional supplementation in malnourished older haemodialysis patients: Towards better quality of life and autonomy. Nephrology (Carlton). 2016;21(9):785-90.
Hristea, D., Deschamps, T., Paris, A., Lefrançois, G., Collet, V., Savoiu, C., ... Magnard, J. (2016). Combining intra-dialytic exercise and nutritional supplementation in malnourished older haemodialysis patients: Towards better quality of life and autonomy. Nephrology (Carlton, Vic.), 21(9), pp. 785-90. doi:10.1111/nep.12752.
Hristea D, et al. Combining Intra-dialytic Exercise and Nutritional Supplementation in Malnourished Older Haemodialysis Patients: Towards Better Quality of Life and Autonomy. Nephrology (Carlton). 2016;21(9):785-90. PubMed PMID: 26890997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combining intra-dialytic exercise and nutritional supplementation in malnourished older haemodialysis patients: Towards better quality of life and autonomy. AU - Hristea,Dan, AU - Deschamps,Thibault, AU - Paris,Anne, AU - Lefrançois,Gaëlle, AU - Collet,Valérie, AU - Savoiu,Corneliu, AU - Ozenne,Sophie, AU - Coupel,Stéphanie, AU - Testa,Angelo, AU - Magnard,Justine, PY - 2015/12/03/received PY - 2016/02/06/revised PY - 2016/02/14/accepted PY - 2016/2/19/entrez PY - 2016/2/19/pubmed PY - 2017/2/28/medline KW - aging KW - intra-dialytic exercise KW - nutrition KW - protein energy wasting KW - quality of life SP - 785 EP - 90 JF - Nephrology (Carlton, Vic.) JO - Nephrology (Carlton) VL - 21 IS - 9 N2 - Protein-energy wasting (PEW), defined as a loss of body protein mass and fuel reserves, is a powerful predictor of adverse outcomes in haemodialysis (HD) patients. Robust arguments suggest that intra-dialytic exercise, combined with oral/parenteral nutrition, enhances the effect of nutritional interventions in HD patients. This pilot randomized controlled trial investigated the feasibility and the effects of a 6 month intra-dialytic cycling program combined to a nutritional support on PEW, physical functioning (gait, balance, muscle strength) and quality of life (QoL) in older HD patients (mean age 69.7 ± 14.2 years).Twenty-one patients fulfilling diagnostic criteria of PEW were randomly assigned to Nutrition-Exercise group (GN-Ex , n = 10) or Nutrition group (GN , n = 11). Both groups received nutritional supplements in order to reach recommended protein and energy intake goals. In addition GN-Ex completed a cycling program. No significant difference between groups was found in the number of patients having reached remission of PEW. Likewise, no change was observed in serum-albumin, -prealbumin, C-reactive protein, body mass index, lean- and fat-tissue index, or quadriceps force. Interestingly, we found positive effects of exercise on physical function and QoL for the GN-Ex , as evidenced by a significant improvement in the 6-min walk test (+22%), the absence of decline in balance (unlike the GN), and a noteworthy increase in QoL (+53%). Combining intra-dialytic exercise and nutrition in HD patients is feasible, and well accepted, improves physical function and QoL but it appears not to have the potential to reverse PEW. SN - 1440-1797 UR - https://www.unboundmedicine.com/medline/citation/26890997/Combining_intra_dialytic_exercise_and_nutritional_supplementation_in_malnourished_older_haemodialysis_patients:_Towards_better_quality_of_life_and_autonomy_ L2 - https://doi.org/10.1111/nep.12752 DB - PRIME DP - Unbound Medicine ER -