Effects of Physical Activities on the Expression of Nrf2 and Nf-kb Hemodialysis Patients

Not Applicable

Completed

• Conditions: Chronic Kidney Disease; Diabetes; Hypertension
• Interventions: Other: physical exercises

• Registration Number: NCT02718638
• Lead Sponsor: Universidade Federal Fluminense

Brief Summary

Oxidative stress and inflammation are cardiovascular risk factors in patients with chronic kidney disease (CKD) undergoing hemodialysis (HD). Nuclear transcription factors play roles in the coordinated expression of genes involved in inflammation, such as nuclear factor Kappa B (NFkB) that increase the cytokines synthesis and Nuclear factor erythroid 2-related factor 2 (Nrf2) that increase the transcription of genes encoding enzymes of phase II detoxifying and antioxidant enzymes. The aim of this study was to evaluate the effects of resistance exercise program on the expression of transcription factors Nrf2 and NF-kB in HD patients.

Detailed Description

This study included 44 patients on regular HD program which 25 patients (54.5% women, age 45.7 ± 15.2 years and time on dialysis, 71.2 ± 45.5 months) composed the exercise group and 19 patients (61.5% women, age 42.5 ± 13.5 years and time on dialysis, 70.1 ± 49.9 months) the control group. The exercise program was performed during HD sessions, 3 times a week (36 exercises sessions). Peripheral blood mononuclear cells (PBMC) were isolated and processed for expression of Nrf2, NF-kB and NADPH quinone oxidoreductase 1 (NQO1) by quantitative real-time polymerase chain reaction. Antioxidant enzymes activity (catalase-CAT and glutathione peroxidase-GPx), high-sensitivity C-reactive protein (hs-CRP) and nitric oxide (NO) products were assessed using an enzyme-linked immunosorbent assay (ELISA).

Study Timeline

• Study Start: 2013-01
• Primary Completion: 2015-11
• Study First Submitted: 2015-12-01
• Study First Submitted QC: 2016-03-23
• Study First Posted: 2016-03-24
• Status Verified: 2020-10
• Study Completion: 2020-10
• Last Update Submitted: 2020-10-18
• Last Update Posted: 2020-10-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

• Inclusion criteria were age >18 years
• Without any motor skill disorders, arteriovenous fistula for vascular access in the upper limb and patients on maintenance dialysis for at least 6 months.

Exclusion Criteria

• Patients with autoimmune diseases, cancer, infectious diseases, acquired immunodeficiency syndrome, uncontrolled hypertension, unstable angina, malignant arrhythmias, pregnant, lower limb amputee, history of stroke, neurological or cardiovascular disease (moderate-intensity physical activity is not routinely recommended)
• Taking catabolizing drugs
• Under regular exercise
• Smokers
• Patients who complied with <75 % of the training were excluded.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
physical exercises group	physical exercises	Physical exercises were performed during HD sessions, at second hour of HD, three times per week for 3 months (36 sessions). The patients remained seated while performing the exercises that were performed in both lower limbs. Ankle-cuffs and elastic bands (Theraband®, Akron-OH, USA) were used for performed the exercises. The physical exercises consisted of four different exercises and they were administered by a physical therapist following the adapted protocol.

Primary Outcome Measures

Name	Time	Method
Changes in Nrf2 expression	changes in Nrf2 expression from baseline and 3 months	analysed by PCR real time
Changes in cytokines plasma levels	changes in cytokines plasma levels from baseline and 3 months	cytokines plasma levels like interleukin-6, TNF-alpha evaluated by ELISA methods

Trial Locations

Locations (1)

Denise Mafra; 🇧🇷 Rio de Janeiro, RJ, Brazil