Concerns about the application of resistance exercise with blood-flow restriction and thrombosis risk in hemodialysis patients.
Blood-flow restriction
Chronic kidney disease
Coagulation
Hemodialysis: Nephrology
Vascular occlusion exercises
Journal
Journal of sport and health science
ISSN: 2213-2961
Titre abrégé: J Sport Health Sci
Pays: China
ID NLM: 101606001
Informations de publication
Date de publication:
29 Feb 2024
29 Feb 2024
Historique:
received:
16
08
2023
revised:
10
11
2023
accepted:
06
12
2023
medline:
3
3
2024
pubmed:
3
3
2024
entrez:
2
3
2024
Statut:
aheadofprint
Résumé
Hemodialysis (HD) per se is a risk factor for thrombosis. Considering the growing body of evidence on blood-flow restriction (BFR) exercise in HD patients, identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model. The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise (RE) with BFR on this molecule. Two hundred and six HD patients volunteered for this study (all with a glomerular filtration rate below 15 mL/min/1.73m Several variables were associated with elevated levels of D-dimer, including higher blood glucose, citrate use, recent cardiovascular events, recent intercurrents, higher inflammatory status, catheter as vascular access, older patients (>70 years old), and HD vintage. Furthermore, RE + BFR significantly increases D-dimer after 4 h. Patients with borderline baseline D-dimer levels (400-490 ng/mL) displayed increased risk of elevating D-dimer over the normal range (>500 ng/mL). These results identified factors associated with a heightened pro-thrombotic state and may assist in the screening process for HD patients who wish to undergo RE + BFR. D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE + BFR.
Sections du résumé
BACKGROUND
BACKGROUND
Hemodialysis (HD) per se is a risk factor for thrombosis. Considering the growing body of evidence on blood-flow restriction (BFR) exercise in HD patients, identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model. The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise (RE) with BFR on this molecule.
METHODS
METHODS
Two hundred and six HD patients volunteered for this study (all with a glomerular filtration rate below 15 mL/min/1.73m
RESULTS
RESULTS
Several variables were associated with elevated levels of D-dimer, including higher blood glucose, citrate use, recent cardiovascular events, recent intercurrents, higher inflammatory status, catheter as vascular access, older patients (>70 years old), and HD vintage. Furthermore, RE + BFR significantly increases D-dimer after 4 h. Patients with borderline baseline D-dimer levels (400-490 ng/mL) displayed increased risk of elevating D-dimer over the normal range (>500 ng/mL).
CONCLUSION
CONCLUSIONS
These results identified factors associated with a heightened pro-thrombotic state and may assist in the screening process for HD patients who wish to undergo RE + BFR. D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE + BFR.
Identifiants
pubmed: 38431193
pii: S2095-2546(24)00023-1
doi: 10.1016/j.jshs.2024.02.006
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Production and hosting by Elsevier B.V.
Déclaration de conflit d'intérêts
Competing interests NR is the founder of THE BFR PROS, a BFR education company that provides BFR training workshops to fitness and rehabilitation professionals across the world using a variety of BFR devices. The other authors declare that they have no other competing interests.