Background: Hemodialysis patients are suffering from depressive symptoms. Brain-derived neurotrophic factor (BDNF) levels are negatively associated with depressive symptoms and decrease during a single hemodialysis session. Resistance training (RT) might be an additional non-pharmacological tool to increase BDNF and promote mental health. Methods: Two randomized groups of hemodialysis patients: control (CTL, n = 76/F36; 66.33 ± 3.88 years) and RT (n = 81/F35; 67.27 ± 3.24 years). RT completed six months of training thrice a week under the supervision of strength and conditioning professional immediately before the dialysis session. Training loads were adjusted using the OMNI rating of perceived exertion. The total antioxidant capacity (TROLOX), glutathione (GSH), thiobarbituric acid reactive substance (TBARS), and BDNF levels were analyzed in serum samples. Quality of life (assessed through Medical Outcomes—SF36), and Beck Depression Inventory was applied. Results: RT improved handgrip strength (21.17 ± 4.38 vs. 27.17 ± 4.34; p = 0.001) but not for CTL (20.09 ± 5.19 vs. 19.75 ± 5.54; p = 0.001). Post-training, RT group had higher values as compared to CTL related to TROLOX (RT,680.8 ± 225.2 vs. CTL,589.5 ± 195.9; p = 0.001) and GSH (RT, 9.33 ± 2.09 vs. CTL,5.00 ± 2.96; p = 0.001). RT group had lower values of TBARS as compared to CTL at post-training (RT, 11.06 ± 2.95 vs. CTL, 13.66 ± 2.62; p = 0.001). BDNF increased for RT (11.66 ± 5.20 vs. 19.60 ± 7.23; p = 0.001), but decreased for CTL (14.40 ± 4.99 vs. 10.84 ± 5.94; p = 0.001). Quality of life and mental health increased (p = 0.001) for RT, but did not change for CTL (p = 0.001). BDNF levels were associated with emotional dimensions of SF36, depressive symptoms, and handgrip (p = 0.001). Conclusions: RT was effective as a non-pharmacological tool to increased BDNF levels, quality of life, temper the redox balance and decrease depressive symptoms intensity in hemodialysis patients.

The aim of this study was to compare the effect of dynamic (DRT) and isometric (IRT) resistance training on glycemic homeostasis, lipid profile, and nitric oxide (NO) in hemodialysis (HD) patients. Patients were randomly distributed into 3 groups: control (n = 65), DRT (n = 65), and IRT (n = 67). Patients assessed before and after the intervention period were tested for fasting blood glucose, glycated hemoglobin, oral glucose tolerance test, insulin resistance, lipid profile, leptin, insulin, adiponectin, C-reactive protein, and NO . Patients underwent to strength and body composition assessments. Subjects allocated in both DRT and IRT groups took part in a 24-week resistance training program, 3 times per week. Each training session was approximately 1 hour before dialysis and consisted of 3 sets of 8–12 repetitions at low intensity. Total workload was higher in the DRT as compared with the IRT. This heightened workload related to better glycemic homeostasis in HD patients as measured by regulation of insulin, adiponectin, and leptin, while improveing triglycerides, free-fat mass, and muscle strength. Additionally, NO levels were increased in the DRT group. NO was significantly correlated with glucose intolerance (r = −0.42, p = 0.0155) and workload (r = 0.46, p = 0.0022). The IRT group only improved strength (p < 0.05). Twenty-four weeks of DRT improved glycemic homeostasis, lipid profile, and NO in HD patients. Although IRT seems to play an important role in increasing strength, DRT might be a better choice to promote metabolic adjustments in HD patients. Clinical trial: http://www.ensaiosclinicos.gov.br/rg/RBR-3gpg5w . Novelty: DRT might be a better choice for metabolic improvements in patients with chronic kidney disease (CKD). Exercise-training might treat metabolic imbalance in CKD patients.

We sought to investigate the effects of resistance training (RT) combined with erythropoietin (EPO) and iron sulfate on the hemoglobin, hepcidin, ferritin, iron status, and inflammatory profile in older individuals with end-stage renal disease (ESRD). ESRD patients (n: 157; age: 66.8 ± 3.6; body mass: 73 ± 15; body mass index: 27 ± 3), were assigned to control (CTL; n: 76) and exercise groups (RT; n: 81). The CTL group was divided according to the iron treatment received: without iron treatment (CTL—none; n = 19), treated only with iron sulfate or EPO (CTL—EPO or IRON; n = 19), and treated with both iron sulfate and EPO (CTL—EPO + IRON; n = 76). The RT group followed the same pattern: (RT—none; n = 20), (RT—EPO or IRON; n = 18), and (RT—EPO + IRON; n = 86). RT consisted of 24 weeks/3 days per week at moderate intensity of full-body resistance exercises prior to the hemodialysis section. The RT group, regardless of the iron treatment, improved iron metabolism in older individuals with ESRD. These results provide some clues on the effects of RT and its combination with EPO and iron sulfate in this population, highlighting RT as an important coadjutant in ESRD-iron deficiency.

Reis, AL, Deus, LA, Neves, RVP, Corrêa, HL Reis, TL, Aguiar, LS Honorato, FS, Barbosa, JMS, Araújo, TB, Palmeira, TRC, Simões, HG, Prestes, J, Sousa, CV, Ide, BN, and Rosa, TdS. Exercise-induced transient oxidative stress is mitigated in Down syndrome: insights about redox balance and muscle strength. J Strength Cond Res 38(3): e125–e34, 2024—This study aimed to evaluate the acute effects of a session of resistance exercise (RE) performed with elastic tubes on the redox balance and inflammatory profile in individuals with Down syndrome (DS). Subjects (n = 23) were allocated into 2 groups: individuals with DS (DS; n = 11) and individuals without DS (WDS; n = 12), who performed an acute RE session. Diagnostic assessment included medical history, anthropometric measures (body height, body mass, body mass index, and body composition assessment), biological collections, muscle strength assessments (handgrip and maximal voluntary isometric contraction tests), and exercises. The redox balance and inflammatory profile were assessed in urine and saliva samples before and after an acute RE session. There were no differences between WDS and DS groups for body composition (p > 0.05). The DS group presented higher values pre and post an acute RE session with elastic tubes for oxidative and proinflammatory markers compared with WDS (p < 0.05). Uric acid values increased from pre–acute RE session to post–acute RE session for WDS (p < 0.0001). No differences were identified within groups for the delta analysis (p > 0.05). Inverse correlations were found between total force and F2-isoprostane, 8OHdG, uric acid, allantoin, IL-6, TNF-α, and the TNF-α:IL-10 ratio. A positive correlation was found between IL-10 and total force. The DS group presented increased peak force in the knee extension and elbow flexion exercises (∼25 and 12%, respectively) but decreases in handgrip strength of ∼7%. The WDS group showed higher peak force values for knee extension, elbow flexion, and handgrip (∼16, 10, and 14%, respectively). The DS group had lower transient elevation of oxidative stress after an acute RE session compared with WDS. Oxidative stress and inflammation responses of DS to an acute RE session with elastic tubes may be insufficient to induce health adaptations for the same relative load compared with WDS.

Sex-specific differences in the prevalence of sarcopenia, dynapenia, and the impact of obesity on muscle strength and quality in patients with chronic kidney disease (CKD) remain underexplored. Background/Objectives: In this cross-sectional study, 78 adults with stage 5 CKD undergoing thrice-weekly maintenance hemodialysis in Brazil (44 men, 34 women; mean ± SD age = 57.55 ± 4.06 years) were assessed. Anthropometry (BMI, waist circumference, waist-to-height ratio), dual-energy X-ray absorptiometry, circulating IL-6, Timed Up and Go, handgrip strength (Jamar ^® dynamometer), and muscle quality index (MQI = handgrip/BMI) were obtained. Dynapenia (handgrip < 27 kg men and < 16 kg women) and sarcopenia (1.0 kg/kg for men and 0.56 kg/kg for women) were classified using EWGSOP2-2018 and FNIH thresholds. Results: Compared with reference values, men showed markedly reduced muscle strength and muscle quality (men: handgrip 21.3 ± 5.1 kg; MQI 0.80 ± 0.23 AU) than women. Also, men were 5.1 times more likely to present with dynapenia (88.6%; 95% CI 2.28–11.60) and 3.15 times more likely to present with sarcopenia (75.0%; 95% CI 1.88–5.30) than women. Waist circumference, waist-to-height ratio, BMI, and body fat % correlated inversely with MQI in both sexes (p ≤ 0.01) and with handgrip strength in men (p ≤ 0.01) but not in women. Conclusions: Among hemodialysis patients, men exhibit a substantially higher burden of dynapenia and sarcopenia than women and excess adiposity is independently associated with poorer muscle quality in both sexes. These findings highlight the need for sex-specific screening cut-offs and integrated strategies targeting both muscle dysfunction and central obesity in CKD management.