Combining intra-dialytic exercise and nutritional supplementation in malnourished older haemodialysis patients: Towards better quality of life and autonomy

Protein‐energy wasting (PEW), defined as a loss of body protein mass and fuel reserves, is a powerful predictor of adverse outcomes in haemodialysis (HD) patients. Robust arguments suggest that intra‐dialytic exercise, combined with oral/parenteral nutrition, enhances the effect of nutritional inter...

Full description

Saved in:
Bibliographic Details
Published in:Nephrology (Carlton, Vic.) Vic.), 2016-09, Vol.21 (9), p.785-790
Main Authors: Hristea, Dan, Deschamps, Thibault, Paris, Anne, Lefrançois, Gaëlle, Collet, Valérie, Savoiu, Corneliu, Ozenne, Sophie, Coupel, Stéphanie, Testa, Angelo, Magnard, Justine
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
aging
Bicycling
Body Composition
Enteral Nutrition
Exercise Therapy - methods
Feasibility Studies
Female
France
Gait
Geriatric Assessment
Humans
intra-dialytic exercise
Kidney Diseases - complications
Kidney Diseases - diagnosis
Kidney Diseases - physiopathology
Kidney Diseases - therapy
Life Sciences
Male
Middle Aged
Muscle Strength
nutrition
Nutritional Status
Nutritional Support - methods
Other
Parenteral Nutrition
Personal Autonomy
Pilot Projects
Postural Balance
protein energy wasting
Protein-Energy Malnutrition - complications
Protein-Energy Malnutrition - diagnosis
Protein-Energy Malnutrition - physiopathology
Protein-Energy Malnutrition - therapy
Quality of Life
Recovery of Function
Renal Dialysis - adverse effects
Risk Factors
Time Factors
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Protein‐energy wasting (PEW), defined as a loss of body protein mass and fuel reserves, is a powerful predictor of adverse outcomes in haemodialysis (HD) patients. Robust arguments suggest that intra‐dialytic exercise, combined with oral/parenteral nutrition, enhances the effect of nutritional interventions in HD patients. This pilot randomized controlled trial investigated the feasibility and the effects of a 6 month intra‐dialytic cycling program combined to a nutritional support on PEW, physical functioning (gait, balance, muscle strength) and quality of life (QoL) in older HD patients (mean age 69.7 ± 14.2 years).Twenty‐one patients fulfilling diagnostic criteria of PEW were randomly assigned to Nutrition‐Exercise group (GN‐Ex, n = 10) or Nutrition group (GN, n = 11). Both groups received nutritional supplements in order to reach recommended protein and energy intake goals. In addition GN‐Ex completed a cycling program. No significant difference between groups was found in the number of patients having reached remission of PEW. Likewise, no change was observed in serum‐albumin, ‐prealbumin, C‐reactive protein, body mass index, lean‐ and fat‐tissue index, or quadriceps force. Interestingly, we found positive effects of exercise on physical function and QoL for the GN‐Ex, as evidenced by a significant improvement in the 6‐min walk test (+22%), the absence of decline in balance (unlike the GN), and a noteworthy increase in QoL (+53%). Combining intra‐dialytic exercise and nutrition in HD patients is feasible, and well accepted, improves physical function and QoL but it appears not to have the potential to reverse PEW.
ISSN:1320-5358
1440-1797
DOI:10.1111/nep.12752