Effects of Exercise Training on Lipid and Carbohydrate Metabolism in Hemodialysis Patients

摘要

A longitudinal study has begun in 14 hemodialysis patients to determine the effects of exercise training on their lipid and carbohydrate metabolism, cardiovascular function, hypertension, anemia, and psychological state. All patients underwent a thorough medical and cardiovascular evaluation prior to entry to insure that none had a disability which would be a contraindication to exercise, and to evaluate their baseline thyroid function, hematologic status, and level of physical fitness. The screening exercise test was a modification of the standardized Bruce protocol. If there were no side effects or abnormal cardiovascular responses during the test, patients entered the protocol. Twelve patients underwent complete evaluations of lipid and carbohydrate metabolism, and 7 hypertensive patients were studied in detail. Investigations included determinations of: (a) lipoprotein and apoprotein profiles; (b) triglyceride turnover rates, lipoprotein lipase activities, intravenous glucose tolerance, and insulin receptor binding, number and affinity; (c) cardiac output, peripheral vascular resistance and ejection fraction; (d) catecholamine, renin, insulin, and glucagon levels; and (e) plasma volume and red cell mass. All patients had baseline psychological profiles, including assessments of mood, health beliefs, and participation in pleasant events. Dietary assessments were performed to determine their caloric intake, the composition of their diet, their cholesterol intake and P/S ratio. Six patients served as 6 month no-exercise controls and 8 began exercising immediately.