Abstracts Division 3

57. Lifestyle Intervention to Increase Muscle Protein Synthesis Rates in Patients with Advanced Chronic Kidney Disease

Dion C.J. Houtvast1, Floris K. Hendriks1, Frank M. van der Sande2, Jeroen P. Kooman2, Luc J.C. van Loon1 

1
Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
2 Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.

Chronic kidney disease (CKD) is characterized by impaired renal function, leading to the accumulation of uremic toxins. The resultant uremic state accelerates the age-related loss of skeletal muscle mass, which is associated with increased morbidity and mortality in patients with CKD. Loss of muscle mass arises when muscle protein breakdown exceeds muscle protein synthesis (MPS). In healthy adults, it has been shown that MPS can be stimulated through exercise training and dietary protein ingestion. However, it remains to be established whether a combined exercise and nutritional intervention can stimulate MPS rates in patients with advanced CKD. Therefore, the current study will compare MPS rates during a 1-week interventional program including resistance-type exercise training and dietary protein supplementation with MPS rates during 1 week of habitual lifestyle in patients with advanced CKD (stage IIIB–V) in a randomized cross-over design.

Throughout the 2-week study period, subjects will ingest deuterated water (2H2O). Body water 2H enrichment will be assessed by means of daily saliva samples and muscle biopsies will be collected at t=0, t=7, and t=14 days to measure muscle 2H enrichment by gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS), which allows for the calculation of MPS rates (%/day). Furthermore, habitual food intake and physical activity levels will be assessed during both study weeks using food diaries and an accelerometer, respectively. The findings of this study will help us gain crucial insights in the efficacy of a combined lifestyle intervention in patients with CKD. Ultimately, this might lead to the clinical implementation of programs focused on improving muscle mass and strength. Such programs could be essential to pre-habilitate patients with advanced CKD prior to kidney transplantation or onset of chronic hemodialysis therapy.

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