Abstract: TH-PO279
Do Baseline Parathyroid Hormone Levels Influence the Effect of Intradialytic Exercise on Bone Turnover Markers in Patients on Haemodialysis?
Session Information
- Hemodialysis and Frequent Dialysis - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Leal, Diogo Vaz, Centro de Investigacao em Desporto Saude e Desenvolvimento Humano, Maia, Maia, Portugal
- Cardoso, Daniela Filipa, Centro de Investigacao em Desporto Saude e Desenvolvimento Humano, Maia, Maia, Portugal
- Andrade, Francini Porcher, Centro de Investigacao em Desporto Saude e Desenvolvimento Humano, Maia, Maia, Portugal
- Martins, Pedro Miguel, Centro de Investigacao em Desporto Saude e Desenvolvimento Humano, Maia, Maia, Portugal
- Ferreira, Manuel A., Nephrocare Portugal SA, Lisboa, Lisboa, Portugal
- Baker, Luke A., Leicester Kidney Lifestyle Team, Leicester, United Kingdom
- Smith, Alice C., Leicester Kidney Lifestyle Team, Leicester, United Kingdom
- Viana, Joao L., Centro de Investigacao em Desporto Saude e Desenvolvimento Humano, Maia, Maia, Portugal
Background
Mineral and bone disorders are common in patients on haemodialysis (HD). We previously observed that regardless of type, exercise appears to have had a modulatory effect on bone remodelling by attenuating bone resorption and maintaining its formation. Parathyroid hormone (PTH) exerts impactful effects on skeletal homeostasis through many mechanisms, with continuous hyperparathyroidism exacerbating both bone formation and resorption. Here we aimed to investigate whether PTH influences the sensitivity of bone biomarkers' responses to exercise training.
Methods
This is a secondary analysis from an RCT completed on 88 HD patients who undertook a 6-week run-in period followed by 12 weeks of intradialytic aerobic (n= 36, male: 66%, age: 67±14 years), or resistance exercise (n= 29, male: 74%, age: 65±14 years), where we combined the exercise groups and stratified patients in low <150 pg/mL (L-PTH), normal 150-600 pg/mL (N-PTH), or high PTH >600 pg/mL (H-PTH). Circulating TRAP-5b, sclerostin, RANKL, osteoprotegerin, and osteocalcin (OCN) were measured by ELISA.
Results
At baseline, there were 15 patients in L-PTH, 55 in N_PTH, and 7 in H-PTH. Most biomarkers were unchanged after the control period, except for a reduction in OCN observed in L-PTH only (p= 0.026). Following exercise, an elevation in TRAP-5b was observed in both L-PTH and N-PTH (p<0.001). No changes in bone biomarkers were observed in patients with H-PTH at any timepoint (p>0.05 in all).
Conclusion
Exercise led to increased bone resorption in patients with low and normal PTH levels and maintained bone formation in patients with low PTH levels, but no such effects were observed in those with high PTH levels. This differential response suggests a protective effect of exercise in patients with low PTH by activating the cycle of bone formation through and increase in resorption and conservation of bone formation, which might be clinically relevant considering their reduced bone turnover.
Funding: The Research Center in Sports Sciences, Health Sciences and Human Development is funded by the Portuguese Foundation of Science and Technology (UID/04045/2020). DC is supported by an FCT doctoral grant (SFRH/BD/138940/2018).
Funding
- Government Support – Non-U.S.