Author(s): MURRI, A., GRAZIOLI, E., CERULLI, C., DI MARCO, L., MARRONE, G., DI LAURO, M., CORNALI, K., MASCI, C., NOCE, A., PARISI, A., Institution: UNIVERSITY OF ROME , Country: ITALY, Abstract-ID: 1689

INTRODUCTION:
Chronic kidney disease (CKD) is associated with several comorbidities, including uremic sarcopenia (US), which negatively influences patients’ health-related quality of life. Dietary-nutritional therapy (DNT) and adapted physical activity (APA) are effective nonpharmacological strategies to counteract the CKD progression and its complications. Among dietary approaches, low-protein diets (LPD) (0.6-0.8 g/kg body weight/day) with controlled intake of phosphorus, sodium, and potassium and adequate energy intake can help mitigate the metabolic imbalances that contribute to US. An alternative DNT, such as the plant-dominant LPD (PLADO), with ≥50% plant-based protein intake, may further slow the CKD progression through modulation of the gut microbiota and reduction of uremic toxins. However, the combined effects of PLADO and APA on the prevention of US remain unclear. This pilot study analyses the impact of a 12-week online APA protocol combined with PLADO or LPD on muscle mass, physical capacity and quality of life in CKD patients.
METHODS:
15 CKD patients, aged 59.8±9.8 years, were randomized into 2 groups: A) Online APA protocol (3 sessions per week, lasting 1 hour each) combined with PLADO; B) Online APA protocol combined with LPD. Physical capacity (6-minute walking test), muscle strength (Handgrip), body composition (bioelectric impedance analysis), quadriceps femoris muscle thickness, and laboratory parameters were evaluated at baseline (T0) and after 12 weeks (T1). SF-36 was administered to assess patients’ general health.
RESULTS:
At T1 Group A and Group B increased the distance in the 6-minute walking test (p=.001; p=.034). Handgrip strength significantly improved in Group A for the left limb (p=.014), showing a positive trend in the right limb as well. In addition, there was a significant reduction in body mass index (BMI) in Group A (p=.022). While quadriceps femoris muscle thickness increased significantly in Group B (p=.050). No significant differences in free oxygen radical defense (FORD) and free oxygen radicals test (FORT) values were observed in both groups. Positive trend was reported in general health perception in both groups, and the item health change increased significantly in Group A (p=.050).
CONCLUSION:
Both PLADO and LPD, combined with APA, seems to positively affect muscle function and body composition of CKD patients. The results suggest that combining dietary interventions with structured exercise may improve health-related quality of life in CKD. Further investigations into long-term outcomes and larger sample are required.