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Abstract: PO2048

Effect of Intradialytic Oral Nutritional Supplementation with and Without Exercise on the Skeletal Muscle Quantity and Quality of Adult Hemodialysis Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Martin-Alemañy, Geovana, Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México, Mexico, Mexico
  • Perez-Navarro, L. Monserrat, Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México, Mexico, Mexico
  • Espinosa-Cuevas, Angeles, National Institute of Medical Science and Nutrtion Salvador Zubira, Ciuad de México, Mexico, Mexico
  • García Villalobos, Gloria Guadalupe, Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México, Mexico, Mexico
  • Medina, Elba O., Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México, Mexico, Mexico
  • Reyes Caldelas, Miguel Angel, Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México, Mexico, Mexico
  • Valdez-Ortiz, Rafael, Hospital General de México, Dr. Eduardo Liceaga, Ciudad de México, Mexico, Mexico
Background

The muscle mass (MM) is one of the major tissues affected by the chronic kidney disease. Patients undergoing chronic hemodialysis (HD) have loss of MM due to many factors. Intradialytic oral nutritional supplementation (ONS) and exercise (EX) have been shown to improve the amount and quality of MM and physical function (PF). We evaluate the effect of the ONS with and without exercise during the HD sessions for 6 months in the quality and quantity of MM in adult HD patients.

Methods

Patients were randomized in two different groups: 1) ONS and 2) EX + ONS. Patient’s realized 30 minutes of aerobic EX using static bicycles and 30 minutes of resistance EX using Theraband Bands. Quantity and quality of MM were measured with anthropometrics and computed tomography (CT). PF was measured by short physical performance battery (SPPB), six-minute walk test (6 MWT) and handgrip strenght (HGS)). According to the data distribution Student t test or Mann-Whitney test were used to analyze the data.

Results

Twenty-three patients conclude the study. Both groups improves their weight (ONS: baseline,53 ± 5.4kg; final, 54.3 ± 4.9kg; p = 0.020 and ONS + EX: baseline, 57.2 ± 9.2kg; final: 59 ± 9.2kg; p = 0.001) and the AMC (ONS: baseline, 227 ± 20mm; final; 241 ± 19mm; p = 0.040 and ONS + EX, baseline: 235 ± 27mm, final: 250 ± 31; p = 0.047). In the ONS group we observed decreases in the 6MWT; baseline: 417 ± 53.9m, final: 405 ± 52m; p= 0.016 and improvements in the SPPB; baseline:10.8 ± 1.3, final: 11.2 ± 1.4, p= 0.005) with no change in the intramuscular lipid infiltration (baseline: 53.5 ± 5.8UH, final: 53.5 ± 3.9UH; p= N.S.). The EX group had improvements in the 6MWT, HGS and in the SPPB (baseline: 383 ± 58m, final: 425 ± 46m; p= 0.000; baseline: 22.6 ± 8.8kg, final: 24.8 ± 8kg, p= 0.000 and baseline: 10.2 ± 1.1, final: 10.8 ± 1.4, p= 0.801, respectively) with decreases in the intramuscular lipid infiltration (baseline: 53.1 ± 4.5HU, final: 55 ± 3.8HU; p= 0.093).

Conclusion

Exercise training for 6 months improves the MM composition of HD patients measured by CT and this was reflected with the improvements in the PF tests and no changes were observed in MM composition in the ONS group.

Funding

  • Private Foundation Support