Exercise improves albumin fractional synthetic rate in chronic hemodialysis patients

Abstract

Objective: To determine whether exercise augments the improvements in fractional synthetic rate (FSR) of albumin observed with nutrition alone. Design: Randomized crossover study. Each patient randomly participated in two protein metabolism kinetic studies using primed-constant infusion of (13C) leucine 2 h before, during and 2 h after hemodialysis. Plasma enrichments of (13C) leucine and (13C) ketoisocaproate were examined to determine the FSR of albumin. Setting: General Clinical Research Center at Vanderbilt University Medical Center. Subjects: Five chronic hemodialysis (CHD) patients. Interventions: Intra-dialytic parenteral nutrition (IDPN) with or without exercise. Results: Exercise performance during hemodialysis significantly improves the FSR of albumin beyond what is observed with IDPN alone (26.2 ± 3.1% per day versus 17.7 ± 1.9% per day, P < 0.05). Conclusion: Exercise improves albumin fractional synthetic rate beyond what is observed with IDPN alone in the acute setting in CHD patients.