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Arazi H, Mohabbat M, Saidie P, Falahati A, Suzuki K. Effects of Different Types of Exercise on Kidney Diseases. Sports (Basel) 2022; 10:sports10030042. [PMID: 35324651 PMCID: PMC8952011 DOI: 10.3390/sports10030042] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/26/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022] Open
Abstract
The effects of exercise on kidney function have been studied for more than three decades. One of the most common health issues among patients with chronic kidney disease (CKD) is a lack of physical activity, which leads to a low exercise capacity in these patients. The majority of maintenance hemodialysis (MHD) patients do not exercise at all. At each stage of dialysis, patients lose 10–12 g of their amino acids through blood sampling. Dialysis also leads to increased cortisol and circadian rhythm sleep disorders in hemodialysis (HD) patients. Studies have also reported higher C-reactive protein levels in HD patients, which causes arterial stiffness. Exercise has a variety of health benefits in these patients, including improved blood pressure control, better sleep, higher physical function, and reduced anxiety and depression. On the other hand, it should be noted that intense exercise has the potential to progress KD, especially when conducted in hot weather with dehydration. This review aimed to investigate the effects of different types of exercise on kidney disease and provide exercise guidelines. In conclusion, moderate-intensity and long-term exercise (for at least a 6-month period), with consideration of the principles of exercise (individualization, intensity, time, etc.), can be used as an adjunctive treatment strategy in patients undergoing dialysis or kidney transplantation.
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Affiliation(s)
- Hamid Arazi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht 4199843653, Iran; (M.M.); (P.S.); (A.F.)
- Correspondence: (H.A.); (K.S.); Tel.: +98-911-139-9207 (H.A.)
| | - Majid Mohabbat
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht 4199843653, Iran; (M.M.); (P.S.); (A.F.)
| | - Payam Saidie
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht 4199843653, Iran; (M.M.); (P.S.); (A.F.)
| | - Akram Falahati
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht 4199843653, Iran; (M.M.); (P.S.); (A.F.)
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
- Correspondence: (H.A.); (K.S.); Tel.: +98-911-139-9207 (H.A.)
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Vallejo AN, Mroczkowski HJ, Michel JJ, Woolford M, Blair HC, Griffin P, McCracken E, Mihalik SJ, Reyes‐Mugica M, Vockley J. Pervasive inflammatory activation in patients with deficiency in very-long-chain acyl-coA dehydrogenase (VLCADD). Clin Transl Immunology 2021; 10:e1304. [PMID: 34194748 PMCID: PMC8236555 DOI: 10.1002/cti2.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 05/06/2021] [Accepted: 06/03/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Very-long-chain acyl-CoA dehydrogenase deficiency (VLCADD) is a disorder of fatty acid oxidation. Symptoms are managed by dietary supplementation with medium-chain fatty acids that bypass the metabolic block. However, patients remain vulnerable to hospitalisations because of rhabdomyolysis, suggesting pathologic processes other than energy deficit. Since rhabdomyolysis is a self-destructive process that can signal inflammatory/immune cascades, we tested the hypothesis that inflammation is a physiologic dimension of VLCADD. METHODS All subjects (n = 18) underwent informed consent/assent. Plasma cytokine and cytometry analyses were performed. A prospective case analysis was carried out on a patient with recurrent hospitalisation. Health data were extracted from patient medical records. RESULTS Patients showed systemic upregulation of nine inflammatory mediators during symptomatic and asymptomatic periods. There was also overall abundance of immune cells with high intracellular expression of IFNγ, IL-6, MIP-1β (CCL4) and TNFα, and the transcription factors p65-NFκB and STAT1 linked to inflammatory pathways. A case analysis of a patient exhibited already elevated plasma cytokine levels during diagnosis in early infancy, evolving into sustained high systemic levels during recurrent rhabdomyolysis-related hospitalisations. There were corresponding activated leukocytes, with higher intracellular stores of inflammatory molecules in monocytes compared to T cells. Exposure of monocytes to long-chain free fatty acids recapitulated the cytokine signature of patients. CONCLUSION Pervasive plasma cytokine upregulation and pre-activated immune cells indicate chronic inflammatory state in VLCADD. Thus, there is rationale for practical implementation of clinical assessment of inflammation and/or translational testing, or adoption, of anti-inflammatory intervention(s) for personalised disease management.
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Affiliation(s)
- Abbe N Vallejo
- Division of Pediatric Rheumatology, Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Department of ImmunologyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Children's Hospital of PittsburghUniversity of Pittsburgh Medical CenterPittsburghPAUSA
| | - Henry J Mroczkowski
- Children's Hospital of PittsburghUniversity of Pittsburgh Medical CenterPittsburghPAUSA
- Division of Genetic and Genomic Medicine, Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Present address:
Department of PediatricsUniversity of Tennessee Health Sciences CenterMemphisTNUSA
| | - Joshua J Michel
- Division of Pediatric Rheumatology, Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Michael Woolford
- Division of Pediatric Rheumatology, Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Harry C Blair
- Department of PathologyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Department of Cell BiologyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Pittsburgh Veterans Administration Medical CenterPittsburghPAUSA
| | - Patricia Griffin
- Division of Pediatric Rheumatology, Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Elizabeth McCracken
- Children's Hospital of PittsburghUniversity of Pittsburgh Medical CenterPittsburghPAUSA
- Division of Genetic and Genomic Medicine, Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Center for Rare Disease and TherapyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Stephanie J Mihalik
- Division of Genetic and Genomic Medicine, Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Department of PathologyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Miguel Reyes‐Mugica
- Children's Hospital of PittsburghUniversity of Pittsburgh Medical CenterPittsburghPAUSA
- Department of PathologyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Jerry Vockley
- Children's Hospital of PittsburghUniversity of Pittsburgh Medical CenterPittsburghPAUSA
- Division of Genetic and Genomic Medicine, Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Center for Rare Disease and TherapyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Department of Human GeneticsUniversity of Pittsburgh Graduate School of Public HealthPittsburghPAUSA
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Hooper DR, Orange T, Gruber MT, Darakjian AA, Conway KL, Hausenblas HA. Broad Spectrum Polyphenol Supplementation from Tart Cherry Extract on Markers of Recovery from Intense Resistance Exercise. J Int Soc Sports Nutr 2021; 18:47. [PMID: 34126996 PMCID: PMC8204440 DOI: 10.1186/s12970-021-00449-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 06/02/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Tart cherry supplementation has been shown to enhance recovery from strenuous exercise due to its antioxidant properties. The majority of these studies used tart cherry juice, with a significant calorie content. The primary purpose of this study was to assess whether powdered tart cherry extract with minimal calorie content reduces oxidative stress and enhances recovery following intense resistance exercise. METHODS Thirteen men (mean age: 26.2 ± 5.3 years; height: 184.3 ± 8.2 cm; weight: 92.9 ± 15.6 kg) performed a demanding resistance exercise protocol consisting of 6 sets of 10 repetitions of barbell back squat with 80% 1RM. The protocol was performed once following 7 days of 500 mg of tart cherry extract and once following placebo. Serum protein carbonyl (PC) content, creatine kinase activity (CK) and creatine kinase myocardial band content (CK-MB) were used to assess oxidative stress, skeletal and cardiac muscle damage respectively. Muscle soreness was assessed by visual analog scale. Physical performance was measured by countermovement jump power and handgrip dynamometer strength. RESULTS There was a significant increase in PC in the placebo (PL) condition when compared to the Tart Cherry (TC) condition at Immediate Post (IP) (PL: 0.4 ± 0.3 vs. TC: - 0.4 ± 0.2 nmol∙mg- 1; p < 0.001), 1 h (PL: 0.3 ± 0.3 vs. TC: - 0.7 ± 0.3 nmol∙mg- 1; p < 0.001) and 24 h (PL: 0.1 ± 0.4 vs. TC: - 0.3 ± 0.5 nmol∙mg- 1; p = 0.010). There was a significant increase in CK activity in PL when compared to the TC at IP (PL: 491.1 ± 280 vs. TC: 296.3 ± 178 U∙L- 1; p = 0.008) and 3 h (PL: - 87 ± 123 vs. TC: 43.1 ± 105.3 U∙L- 1; p = 0.006). There was a significant (p = 0.003) increase in CKMB concentration in PL when compared to the TC (PL: 21.6 ± 12.4 vs. TC: - 0.3 ± 11.8 ng∙ml- 1; p = 0.006) at 1 h post. There was a significant increase in handgrip strength in TC when compared to PL (PL: - 2 ± 5.1 vs. TC: 1.7 ± 3 kg; p = 0.017) at 24 h post. CONCLUSIONS This study demonstrated that tart cherry extract reduced oxidative stress and markers of muscle and cardiac damage following intense resistance exercise. This occurred along with a prevention of the decrease in handgrip strength seen following the intense exercise protocol, indicating a potential reduction in central fatigue. These benefits were seen with minimal energy intake.
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Affiliation(s)
- D R Hooper
- Center for Health and Human Performance, Jacksonville University, Jacksonville, USA. .,Department of Kinesiology, Brooks Rehabilitation College of Healthcare Sciences, Health Sciences Complex, Jacksonville University, 2800 University Boulevard North, Jacksonville, FL, 32211, USA.
| | - T Orange
- Center for Health and Human Performance, Jacksonville University, Jacksonville, USA
| | - M T Gruber
- Department of Biology and Marine Science, Jacksonville University, Jacksonville, USA
| | - A A Darakjian
- Department of Biology and Marine Science, Jacksonville University, Jacksonville, USA
| | - K L Conway
- Department of Biology and Marine Science, Jacksonville University, Jacksonville, USA
| | - H A Hausenblas
- Center for Health and Human Performance, Jacksonville University, Jacksonville, USA.,Department of Kinesiology, Brooks Rehabilitation College of Healthcare Sciences, Health Sciences Complex, Jacksonville University, 2800 University Boulevard North, Jacksonville, FL, 32211, USA
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Jacob N, Novaes JS, Behm DG, Vieira JG, Dias MR, Vianna JM. Characterization of Hormonal, Metabolic, and Inflammatory Responses in CrossFit® Training: A Systematic Review. Front Physiol 2020; 11:1001. [PMID: 32982775 PMCID: PMC7485252 DOI: 10.3389/fphys.2020.01001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/23/2020] [Indexed: 01/04/2023] Open
Abstract
Background: CrossFit® training is a high-intensity functional training program that aims to increase physical functional performance through biochemical responses, i.e., hormonal, metabolic, and inflammatory responses. Most hormonal, metabolic, and inflammatory changes induced by CrossFit® training have been reported in isolated clinical studies. The purpose of this review was to systematically explore the existing literature on characterization of hormonal, metabolic, and inflammatory responses resulting from CrossFit® training. Methods: A systematic search of the literature was conducted in PubMed, Web of Science and Scopus from August 2019 to October 2019. Studies were selected through critical review of the content. Using specific keywords, 623 articles were found, of which 597 were excluded for ineligibility, and 25 were eligible. The papers were separated according to subject area: hormonal (n = 8), metabolic (n = 19), and inflammatory (n = 6) changes. All were published between 2015 and 2019. Results: This review reveals potential effects of CrossFit® training on hormonal, metabolic, and inflammatory responses. However, studies had low levels of evidence and reliability due to methodological limitations. Conclusion: In summary, the results showed a greater volume and intensity of workouts accentuate the responses, that are of paramount importance for improving understanding of the effects of CrossFit® training and serve as a basis for prescribing future exercise protocols.
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Affiliation(s)
- Nacipe Jacob
- Medical and Health Sciences College of Juiz de Fora - Suprema, Juiz de Fora, Brazil
| | - Jefferson S. Novaes
- Postgraduate Program in Physical Education of Federal University of Juiz de Fora, Juiz de Fora, Brazil
- Department of Gymnastics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - David G. Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - João G. Vieira
- Postgraduate Program in Physical Education of Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Marcelo R. Dias
- Postgraduate Program in Physical Education of Federal University of Juiz de Fora, Juiz de Fora, Brazil
- Laboratory of Exercise Physiology and Morphofunctional Assessment of Granbery Methodist College, Juiz de Fora, Brazil
| | - Jeferson M. Vianna
- Postgraduate Program in Physical Education of Federal University of Juiz de Fora, Juiz de Fora, Brazil
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High intensity resistance training causes muscle damage and increases biomarkers of acute kidney injury in healthy individuals. PLoS One 2018; 13:e0205791. [PMID: 30399190 PMCID: PMC6219767 DOI: 10.1371/journal.pone.0205791] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/02/2018] [Indexed: 12/29/2022] Open
Abstract
PURPOSE High-intensity interval resistance training (HIIRT) is an increasingly popular exercise program that provides positive results with short sessions. This study aimed to evaluate whether an HIIRT session causes muscle and kidney damage. METHODS Fifty-eight healthy volunteers (median age 24 years, 50% women) participated in this study and performed a HIIRT session. The Borg CR10 scale for pain (CR10P) and blood and urine samples were collected before (baseline) and 2 and 24 hours after the HIIRT session. Blood samples were analyzed for serum creatinine (SCr), creatine kinase (CK) and myoglobin. Urine samples were assessed for creatinine, neutrophil gelatinase-associated lipocalin, interleukin 18, calbindin, microalbuminuria, trefoil factor-3 and β-2 microglobulin. RESULTS CR10P had a significant increase at 2 and 24 hours post-workout, and CK increased significantly at 2 hours and increased further at 24 hours. Myoglobin increased significantly at 2 hours and remained elevated at 24 hours. SCr increased modestly but significantly at 24 hours only in men. Three men met the KDIGO diagnostic criteria for acute kidney injury. The urinary kidney injury biomarkers increased significantly at 2 hours and returned to the baseline values 24 hours after HIIRT. CONCLUSIONS A single HIIRT session caused early and significant elevations in CK, myoglobin, SCr, microalbuminuria and urinary biomarkers indicative of kidney tubular injury, suggesting the occurrence of muscle and kidney damage.
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Tibana RA, de Sousa NMF. Are extreme conditioning programmes effective and safe? A narrative review of high-intensity functional training methods research paradigms and findings. BMJ Open Sport Exerc Med 2018; 4:e000435. [PMID: 30498574 PMCID: PMC6243133 DOI: 10.1136/bmjsem-2018-000435] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 12/05/2022] Open
Abstract
Extreme conditioning programmes (ECPs, eg, CrossFit, Insanity and Gym Jones) are a growing fitness regimen characterised by functional movements performed at high-intensity and with constantly varying movements. While the popularity and number of practitioners of ECPs are growing, a debate has been established between what is observed in the scientific literature and anecdotal reports from athletes, coaches and physicians about safety (incidence and prevalence of injuries and rhabdomyolysis) and benefits (physical and mental health). In this article, we review the prevalence and incidence of injuries, rhabdomyolysis, physiological responses and chronic adaptations to ECPs. The majority of the available evidence confirm that the estimated injury rate among athletes participating in ECPs is similar to that in weightlifting and most other recreational activities. Additionally, ECP sessions resulted in increased acute oxidative, metabolic and cardiovascular stress, and depending on the stimulus (intensity, duration and non-usual exercise) and training status of the practitioner, an ECP session may precipitate rhabdomyolysis. In the scientific literature, the current chronic effects of ECPs showed little or no effects on body composition and improvements in physical fitness and psychological parameters; however, further studies are important.
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Affiliation(s)
- Ramires Alsamir Tibana
- Department of Physical Education, Federal University of Mato Grosso (UFMT), Cuiabá, MT, Brazil
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Estes MEZ. Rhabdomyolysis after exercise with an electrical muscle stimulator. Nurse Pract 2018; 43:8-12. [PMID: 30134431 DOI: 10.1097/01.npr.0000544286.79459.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Mary Ellen Zator Estes
- Mary Ellen Zator Estes is an NP in internal medicine at PMG Jay C. Tyroler, MD, PC, Fairfax, Va., and a nurse consultant, Vienna, Va
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Tibana RA, Sousa NMFD, Cunha GV, Prestes J, Navalta JW, Voltarelli FA. Exertional Rhabdomyolysis after an Extreme Conditioning Competition: A Case Report. Sports (Basel) 2018; 6:E40. [PMID: 29910344 PMCID: PMC6026788 DOI: 10.3390/sports6020040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/07/2018] [Accepted: 04/23/2018] [Indexed: 02/06/2023] Open
Abstract
This case report describes an instance of exercise-induced rhabdomyolysis caused by an extreme conditioning program (ECP) competition. A 35-year-old female presented with abdominal pain and soreness, which began one day after she completed two days of ECPcompetition composed of five workouts. Three days after competition, creatine kinase (CK) was 77,590 U/L accompanied by myalgia and abnormal liver function tests, while renal function was normal and this resulted in a diagnosis of rhabdomyolysis. A follow-up examination revealed that her serum level of CK was still elevated to 3034 U/L on day 10 and 1257 U/L on day 25 following the ECP competition. The subject reported myalgia even up to 25 days after the ECP competition. Exertional rhabdomyolysis can be observed in ECP athletes following competition and highlights a dangerous condition, which may be increasing in recent years due to the massive expansion of ECP popularity and a growing number of competitions. Future research should investigate the causes of rhabdomyolysis that occur as a result of ECP, especially training methods and/or tasks developed specifically for these competitions.
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Affiliation(s)
- Ramires Alsamir Tibana
- Department of Physical Education, Universidade Federal de Mato Grosso (UFMT), Cuiabá 78000-000, Brazil.
- Graduation Program on Physical Education, Catholic University of Brasilia, Brasilia 72000-000, Brazil.
| | | | - Gabriel Veloso Cunha
- Undergraduate Program in Medicine, Catholic University of Brasilia, Brasilia 72000-000, Brazil.
| | - Jonato Prestes
- Graduation Program on Physical Education, Catholic University of Brasilia, Brasilia 72000-000, Brazil.
| | - James W Navalta
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV 89154, USA.
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