Exercising to offset muscle mass loss in hemodialysis patients: The disconnect between intention and intervention
Exercising to offset muscle mass loss in hemodialysis patients: The disconnect between intention and intervention
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DOI：
10.1111/sdi.12805
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发表时间：
2019-07-01
影响因子：
1.6
通讯作者：
Burd, Nicholas A.
中科院分区：
文献类型：
--
作者：
McKenna, Colleen F.;Salvador, Amadeo F.;Burd, Nicholas A.
骨骼肌损失是蛋白质能量消耗综合征的最重要标志，因为它有助于维持性血液透析（HD）的ESRD患者的身体独立性下降，生活质量下降和死亡风险升高。因此，已经研究了运动和营养干预措施，目的是保持骨骼肌质量和整体生活质量。不幸的是，目前的努力无法证实运动减轻ESRD相关肌肉萎缩的能力。然而，不确定的数据往往伴随着次优的运动处方。在透析治疗的分解代谢和促炎期间，经常在临床上进行运动，同时不进行营养支持。此外，运动不耐受和运动计划依从性/坚持性等间接因素也会抑制运动训练潜力。这些缺点都源于目前对ESRD和间歇性HD背景下的骨骼肌质量调节缺乏了解。因此，本综述总结了目前对运动调节骨骼肌质量和ESRD相关障碍的认识，以说明目前HD患者运动干预的无效性。
Skeletal muscle loss is the most important hallmark of protein energy wasting syndrome as it contributes to declines in physical independence, poor quality of life, and higher mortality risk in individuals with ESRD on maintenance hemodialysis (HD). As such, exercise and nutritional interventions have been investigated with the goal to preserve skeletal muscle mass and overall quality of life. Unfortunately, current efforts are unable to confirm the capacity of exercise to mitigate ESRD-associated muscle wasting. However, the inconclusive data are often accompanied by suboptimal exercise prescriptions. Exercise sessions are often implemented in-clinic during the catabolic and proinflammatory period of dialysis treatment and without concurrent nutritional support. Additionally, indirect considerations like exercise intolerance and exercise program compliance/adherence also inhibit exercise training potential. These shortcomings all stem from the current lack of understanding in skeletal muscle mass regulation within the context of ESRD and intermittent HD. As such, this review summarizes the current understanding of exercise regulation on skeletal muscle mass and ESRD-related obstacles of anabolism to contextualize the ineffectiveness of current exercise interventions for HD patients.