Exercise improves albumin fractional synthetic rate in chronic hemodialysis patients

• Published in: European journal of clinical nutrition Vol. 61; no. 5; pp. 686 - 689
• Main Authors: Pupim, L.B, Flakoll, P.J, Ikizler, T.A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.05.2007; Nature Publishing; Nature Publishing Group
• Subjects: Albumin; Albumins; Albumins - metabolism; analysis; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; blood; Blood products; body composition; Caproates; Caproates - pharmacokinetics; Carbon Isotopes; chronic diseases; Clinical Nutrition; Cross-Over Studies; Emergency and intensive care: renal failure. Dialysis management; Epidemiology; Exercise; Exercise - physiology; Female; fractional synthetic rate; Health care facilities; Hemodialysis; Humans; Intensive care medicine; Internal Medicine; ketoisocaproate; Kidney Failure, Chronic; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - therapy; labeling techniques; Leucine; Leucine - pharmacokinetics; Male; Medical research; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; metabolic studies; metabolism; Middle Aged; Nutrition; nutrition assessment; nutritional status; Parenteral Nutrition; Patients; pharmacokinetics; physiology; Protein metabolism; protein synthesis; Protein turnover; Public Health; Renal Dialysis; Research facilities; serum albumin; Serum Albumin - analysis; short-communication; therapy; synthesis; hemodialysis; exercise; catabolism; albumin; Physical exercise; Human; Nutrition; Hemodialysis; Rate; Albumin; Patient; Extrarenal dialysis; Improvement; Chronic; Synthetic product; Synthesis; Catabolism
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1602578

Objective: To determine whether exercise augments the improvements in fractional synthetic rate (FSR) of albumin observed with nutrition alone. Design: Randomized crossover study. Each patient randomly participated in two protein metabolism kinetic studies using primed-constant infusion of (¹³C) leucine 2 h before, during and 2 h after hemodialysis. Plasma enrichments of (¹³C) leucine and (¹³C) ketoisocaproate were examined to determine the FSR of albumin. Setting: General Clinical Research Center at Vanderbilt University Medical Center. Subjects: Five chronic hemodialysis (CHD) patients. Interventions: Intra-dialytic parenteral nutrition (IDPN) with or without exercise. Results: Exercise performance during hemodialysis significantly improves the FSR of albumin beyond what is observed with IDPN alone (26.2+/-3.1% per day versus 17.7+/-1.9% per day, P<0.05). Conclusion: Exercise improves albumin fractional synthetic rate beyond what is observed with IDPN alone in the acute setting in CHD patients.