Nephrol Dial Transplant (2003) 18: 1854-1861
© 2003 European Renal Association-European Dialysis and Transplant Association
Changes in muscle morphology in dialysis patients after 6 months of aerobic exercise training
1 Centre for Biophysical and Clinical Research into Human Movement, Manchester Metropolitan University, 2 North Staffordshire Hospital Trust, UK, 3 Institute for Fundamental and Clinical Human Movement Sciences, Vrije University, Amsterdam, The Netherlands and 4 University of Edinburgh, PESLS, Edinburgh, UK
Correspondence and offprint requests to: Giorgos K. Sakkas, Department of Medicine, University of California San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Building 30, Room 3501-K, San Francisco, CA 94110, USA. Email: gsakkas{at}itsa.ucsf.edu
Background. In the present study we investigated the effect of a 6-month aerobic exercise programme on the morphology of the gastrocnemius muscle of end-stage renal disease (ESRD) patients.
Methods. Twenty-four ESRD patients volunteered to participate in the training programme and underwent muscle biopsy before training. Eighteen patients completed the training programme of whom nine agreed to a post-training biopsy (one woman and eight men, mean age 56 ± 15 years). Data are presented for the nine subjects who were biopsied before (PRE) and after training (POST) and separately for the 15 subjects for whom we only have a biopsy before training (cross-sectional group).
Results. There were no significant differences (P > 0.05) in fibre type distribution or myosin heavy chain (MyHC) expression between the cross-sectional and PRE/POST groups. The mean cross-section fibre area after training (POST) increased by 46% compared with the PRE training status (P < 0.01). The proportion of atrophic fibres decreased significantly after training in type I, IIa and IIx fibre populations (from 51 to 15%, 58 to 21% and 62 to 32%, respectively). Significant differences were also found in capillary contact per fibre (CC/F), with the muscle having 24% (P < 0.05) more CC/F compared with the PRE training status. No significant differences in cytochrome c oxidase concentration were found between the groups.
Conclusions. In conclusion, exercise appeared to be beneficial in renal rehabilitation by correcting the fibre atrophy, increasing the cross-section fibre area and improving the capillarization in the skeletal muscle of renal failure patients.
Keywords: CAPD; capillary density; cytochrome c oxidase; exercise training; fibre types; gastrocnemius; haemodialysis
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