Kidney Week

Abstract: TH-PO980

Effects of Intradialytic Aerobic Exercises on Mitochondrial Biogenesis Markers in Patients Undergoing Hemodialysis

Session Information

• Physical Activity and Lifestyle in Kidney Diseases
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Mafra, Denise, Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil

Denise Mafra, PhD

• Alvarenga, Livia De almeida, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil

Livia De almeida Alvarenga, PhD

• Cardozo, Ludmila Fmf, Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil

Ludmila Fmf Cardozo, PhD

• Ribeiro-Alves, Marcelo, Fundacao Oswaldo Cruz, Rio de Janeiro, RJ, Brazil

Marcelo Ribeiro-Alves

• Brito, Jessyca Sousa de, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil

Jessyca Sousa de Brito, PhD

Background

Chronic kidney disease (CKD) patients commonly have impaired mitochondrial biogenesis and antioxidant defenses. Therefore, gene transcription factors involved with mitochondrial function, such as the peroxisome proliferator-activated receptor gamma 1 alpha coactivator (PGC-1α), the nuclear respiratory factor-1 gene (NRF1) and the mitochondrial transcription A (TFAM), may have its expression modified in patients with CKD. Furthermore, nuclear factor erythroid 2-related factor 2 (Nrf2), an important antioxidant transcription factor, and antioxidant enzymes such as NQO1: NAD(P)H: quinone oxidoreductase-1 (NQO1) are downregulated in CKD patients contributing to oxidative stress. Thus, the study aimed to evaluate the effects of an aerobic intradialytic exercise program on the expression of mitochondrial function markers and antioxidant function in hemodialysis (HD) patients.

Methods

This was a longitudinal crossover clinical trial that included 18 HD patients [61.1% men; 44 (12.2) years; 23.7 (3.9) kg/m²; dialysis vintage = 17.2 (20.2) months]. Patients were randomized into 2 groups: exercise and control (usual care). The physical exercise program was individualized and performed on an adapted stationary bicycle, consisting of heating (5 minutes), 35 minutes of aerobic training at target heart rate, and cool down (load reduction for 5 minutes), monitored thrice weekly for 3 months. After this, there was one month of washout, crossover, and another 3 months of intervention. Peripheral blood mononuclear cells were isolated and processed to evaluate PGC-1α, NRF1, TFAM, Nrf2, and NQO1 mRNA expression by RT-qPCR.

Results

After the intradialytic exercise program intervention, there was no significant change in the mitochondrial parameters evaluated (PGC-1α, TFAM, and NFR1) nor in the parameters related to antioxidant defenses (Nrf2 and NQO1). Interestingly, a positive correlation was found between PGC-1α and Nrf2 mRNA expression (r=0.38 p=0.04) and between TFAM and NRF1 (r=0.45, p=0.00) at baseline.

Conclusion

Three months of interdialytic aerobic exercise was insufficient to modulate significantly mitochondrial biogenesis markers or increase antioxidant defenses.

Funding

• Government Support – Non-U.S.