This study compared the effectiveness of dynamic resistance training (DRT) versus isometric RT (IRT) on osteogenesis and hormonal mechanisms involved in maintenance hemodialysis (MHD) patients. One hundred and ninety-three MHD patients were randomized into three groups: control (CTL; n=60), DRT (n=66), and IRT (n=67). A first visit was required for an anamnesis to evaluate the number of medications, biochemical and anthropometric measurements (dialysis adequacy, creatinine, urea, body mass, height, and body mass index). Grip strength, bone mineral density (BMD), and renal-bone markers were assessed pre- and post-protocol. The DRT and IRT training was six months with a frequency of three times per week, on alternate days. Each training session consisted of 3 sets of 8 to 12 repetitions at lower and moderate intensities. Both training sessions were prescribed approximately one-hour prior to dialysis. Statistical significances were adopted with p<0.05. There was a greater dropout in the IRT group (24%) as compared with the DRT group (14%), which in turn had less adverse clinical effects (67%, 24%, 61% for CTL, DRT, IRT, respectively). DRT promoted gains in BMD in different body locations, in addition to increasing pro-osteogenic factors (Klotho and calcitriol), and reducing those related to bone loss, such as sclerostin, FGF23, and PTH. There was an improvement in Ca × PO₄³ for DRT, while these benefits did not occur in the IRT group (p<0.05). These novel findings suggest that the DRT generates biopositive adaptations in bone tissue in MHD and can be used as a non-pharmacological strategy to improve BMD.

中文翻译：

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动态非等距训练在维持性血液透析患者中​​通过硬化素/ FGF23 / Klotho轴钝化了骨肾疾病：一项随机临床试验

这项研究比较了动态阻力训练（DRT）和等距RT（IRT）对维持性血液透析（MHD）患者所涉及的成骨和激素机制的有效性。193例MHD患者被随机分为三组：对照组（CTL； n = 60），DRT（n = 66）和IRT（n = 67）。进行记忆检查需要首次访问，以评估药物的数量，生化和人体测量学（透析充分性，肌酐，尿素，体重，身高和体重指数）。协议前后评估握力，骨矿物质密度（BMD）和肾骨标志物。DRT和IRT培训为期六个月，每周三次，隔天一次。每个训练课程包括3组，每组8至12次，分别在中低强度下进行。两次培训均在透析前约一小时进行。采用统计学显着性，p ＜0.05。与DRT组（14％）相比，IRT组的辍学率更高（24％），这反过来对临床的不良影响较小（CTL，DRT和IRT分别为67％，24％，61％） 。除了增加促成骨因子（Klotho和骨化三醇）并减少与骨质流失相关的因子（如硬化素，FGF23和PTH）外，DRT还促进了不同身体部位BMD的增加。Ca×PO有所改善 除了增加促成骨因子（Klotho和骨化三醇）并减少与骨质流失相关的因子（如硬化素，FGF23和PTH）外，DRT还促进了不同身体部位BMD的增加。Ca×PO有所改善 除了增加促成骨因子（Klotho和骨化三醇）并减少与骨质流失相关的因子（如硬化素，FGF23和PTH）外，DRT还促进了不同身体部位BMD的增加。Ca×PO有所改善DRT为₄ ³，而IRT组未出现这些益处（p <0.05）。这些新发现表明，DRT在MHD的骨组织中产生生物阳性适应性变化，可以用作改善BMD的非药物策略。