Kidney Week

Abstract: TH-PO1190

Amino Acids Supplementation and Exercise Intervention in Hemodialysis Patients: Effects on Muscle and Fatigue, A Randomized Controlled Trial

Session Information

• Late-Breaking Science Posters
  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

• Samaan, Emad, Mansoura University Faculty of Medicine, Mansoura, Egypt

Emad Samaan, MD

• Ali, Ammar Yasser, Mansoura University Faculty of Medicine, Mansoura, Egypt

Ammar Yasser Ali, MD

• Moustafa, Ahmed Reda Abdelmeguid, Mansoura University Faculty of Medicine, Mansoura, Egypt

Ahmed Reda Abdelmeguid Moustafa, MBBS, MBChB

• Shahin, Mirna, Mansoura University Faculty of Medicine, Mansoura, Egypt

Mirna Shahin, MBBS, MBChB

• Gamaleldin, Hala Ihab, Mansoura University Faculty of Medicine, Mansoura, Egypt

Hala Ihab Gamaleldin, MD

• Abdelgawad, Sara Mohamed, Mansoura University, Mansoura, Egypt

Sara Mohamed Abdelgawad, MSc, PhD, RN

• Awad, Alaa Ali, Mansoura University Faculty of Medicine, Mansoura, Egypt

Alaa Ali Awad

• Elgamal, Mohamed, Mansoura University Faculty of Medicine, Mansoura, Egypt

Mohamed Elgamal, PhD, MD

• Elberashi, Hanan Mohammed, Mansoura University Faculty of Medicine, Mansoura, Egypt

Hanan Mohammed Elberashi, MBBS

• Sabry, Alaa Abdel-Aziz, Mansoura University Faculty of Medicine, Mansoura, Egypt

Alaa Abdel-Aziz Sabry, MBChB, PhD, FASN

Background

Limited data exists on the effects of intradialytic exercise and ketoanalogue(KA) supplementation on muscle mass, function and fatigue in Hemodialysis (HD) patients

Methods

In a randomized controlled trial, 80 HD patients were assigned to one of four groups: (1) KA supplementation only, (2) intradialytic exercise only, (3) both interventions combined, and (4) a control group with standard care. Over 3 months, KA was given as one tablet per 10 KG of patient weight daily, and exercises included knee extensions, hip abductions with ankle weights. Outcomes measured were muscle mass by bioimpedance, quadriceps rectus femoris and vastus intermedius thickness by ultrasonography (US), functional assessments (sit-to-stand test, hand grip strength), and fatigue (Modified Fatigue Impact Scale (MFIS)).

Results

There were no statistically significant differences in baseline parameters between groups. The KA supplementation only- group showed a statistically significant improvement in MFIS, with median values changing from 26(IQR 37) pre-trial to 16.5(15) post-trial (p=0.01), and in the sit-to-stand test showed significant improvements in the number of unaided trials, with median values increasing from 8.5(7) to 10(7) (p=0.02). Hand grip strength also improved from 22.2(14.7) to 25.6(3.6)(p=0.008). The combined interventions group showed significant MFIS improvement, with median values from 29(32) pre-trial to 24(20) post-trial (p=0.03), and hand grip strength improved from 13.1(10) to 21(14.2)(p=0.006). No significant differences in improvement of fatigue scores or hand grip strength were found between the KA supplementation and combined interventions groups. The intradialytic exercise only- group had a significant increase in hand grip strength from 16.1(13.5) to 21.8(7.8)(p=0.006). The control group showed no significant changes. There were no significant differences among groups in anthropometric measures, quadriceps muscle US measurements, or Skeletal Muscle Index assessed by bioimpedance.

Conclusion

KA supplementation could enhance physical performance in HD patients, as evidenced by improvements in fatigue and functional strength. However, the effects on muscle mass were not significant.