Resistance training may increase iron bioavailability in older patients on hemodialysis (HD), a new study finds.

Investigators assigned 81 patients on HD to an exercise group and 76 to a control group. Mean age was 66.8 years and body mass index was 27 kg/m2. Patients in the intervention arm performed moderate-intensity resistance training 3 days per week (1 hour before their scheduled HD session) for a total of 24 weeks. Each training session consisted of 12 exercises, including chest press, squat, unilateral row, unilateral knee extension, unilateral knee flexion, unilateral shoulder press, hip thrust, unilateral biceps curl, unilateral hip adduction, unilateral hip abduction, unilateral elbow extension with dumbbells, and seated calf raise. To preserve arteriovenous fistulas, upper limb exercises were conservative.

Inflammation eased in the exercise group over 24 weeks: tumor necrosis factor α and interleukin-6 decreased, and interleukin-10 increased. Concurrently,hepcidin significantly decreased by 7.9 ng/mL (whereas it increased by 0.2 ng/mL in the control group). Moreover, iron bioavailability significantly increased by 22.2 μg/dL in the exercise group, while it decreased by 1 μg/dL in the control group, Sting Ray Gouveia Moura of Catholic University of Brasilia, Federal District, Brazil, and colleagues reported in Experimental Gerontology. Hemoglobin and ferritin did not change significantly.

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“These novel findings show that [resistance training] is a potential coadjuvant to reduce iron deficiency by decreasing the levels of hepcidin and pro-inflammatory markers in older patients undergoing hemodialysis,” they wrote.


Moura SRG, Corrêa HL, Neves RVP, et al. Effects of resistance training on hepcidin levels and iron bioavailability in older individuals with end-stage renal disease: A randomized controlled trial [published online July 4, 2020]. Experimental Gerontology. doi: 10.1016/j.exger.2020.111017