Concerns about the application of resistance exercise with blood-flow restriction and thrombosis risk in hemodialysis patients  

作　　者：Hugo de Luca Correa Lysleine Alves Deus Dahan da Cunha Nascimento Nicholas Rolnick Rodrigo Vanerson Passos Neves Andrea Lucena Reis Thais Branquinho de Araujo Carmen Tzanno-Martins Fernanda Silveira Tavares Luiz Sinesio Silva Neto Claudio Avelino Rodrigues Santos Paolo Lucas Rodrigues-Silva Fernando Honorato Souza Vitoria Marra da Motta Vilalva Mestrinho Rafael Lavarini dos Santos Rosangela Vieira Andrade Jonato Prestes Thiago dos Santos Rosa 

机构地区：[1]Post-graduate Program of Physical Education,Catholic University of Brasılia,Brasılia 71966-700,Brazil [2]The Human Performance Mechanic,Lehman College,New York,NY 10011,USA [3]Clinical Group Home Dialysis Center and RenalClass,Sao Paulo 01239-040,Brazil [4]Department of Medicine,Catholic University of Brasılia,Brasılia 71966-700,Brazil [5]Faculty of Medicine,Federal University of Tocantins,Tocantins 77001-090,Brazil [6]Embrapa Genetic Resources and Biotechnology,Brasılia 70770-917,Brazil [7]Graduate Program of Genomic Sciences and Biotechnology,Brasılia 71966-700,Brazil

出　　处：《Journal of Sport and Health Science》2024年第4期548-558,F0003,共12页运动与健康科学（英文）

基　　金：supported by a grant provided by the Coordenacao de Aperfeicoamento de Pessoal de Nível Superior-Brazil-Finance Code 001 and National Council for Scientific and Technological Development;financed in part by the Conselho Nacional de Desenvolvimento Científico e Tecnológico and Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior-Brasil--Finance Code 001;funded by the Fundacao de Apoio à Pesquisa do Distrito Federal with grants from demanda espontanea-Edital 09/2022

摘　　要：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:Two hundred and six HD patients volunteered for this study(all with a glomerular filtration rate of <15 mL/min/1.73 m2).The RE+BFR session consisted of 50% arterial occlusion pressure during 50 min sessions of HD(intradialytic exercise).RE repetitions included concentric and eccentric lifting phases(each lasting 2 s) and were supervised by a strength and conditioning specialist.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:These results identified factors associated with a heightened prothrombotic 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.

关 键 词：Blood-flow restriction Chronic kidney disease COAGULATION HEMODIALYSIS Vascular occlusion exercises 

分 类 号：G804.2[文化科学—运动人体科学] R692.5[文化科学—体育学]