Effects of respiratory muscle training on endothelium and oxidative stress biomarkers in hemodialysis patients: A randomized clinical trial
Hemodialysis (HD) patients have altered pulmonary function and this is associated with impaired endothelial function and cardiovascular events. Respiratory muscle training (RMT) has the potential to improve cardiovascular outcomes in patients undergoing maintenance HD. Here, we evaluated the effects...
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| Veröffentlicht in: | Respiratory medicine 2018-01, Vol.134, p.103-109 |
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| creator | Campos, Nataly Gurgel Marizeiro, Débora Fortes Florêncio, Ana Carolina Lins Silva, Ítalo Caldas Meneses, Gdayllon Cavalcante Bezerra, Gabriela Freire Martins, Alice Maria Costa Libório, Alexandre Braga |
| description | Hemodialysis (HD) patients have altered pulmonary function and this is associated with impaired endothelial function and cardiovascular events. Respiratory muscle training (RMT) has the potential to improve cardiovascular outcomes in patients undergoing maintenance HD. Here, we evaluated the effects of RMT on endothelium/glycocalyx, oxidative stress biomarkers and pulmonary function test in HD patients.
This is a randomized controlled clinical trial including 41 patients undergoing thrice-weekly maintenance HD. Patients were randomly assigned at a 2:1 ratio to receive or not RMT during HD sessions for 8 weeks. Main outcomes were changes in levels of the biomarkers related to endothelium activation (vascular cell adhesion molecule 1, VCAM-1, and intercellular adhesion molecule 1, ICAM-1), glycocalyx derangement (syndecan-1), aberrant angiogenesis (angiopoietin-2) and oxidative stress (malondialdehyde) compared to baseline. Also, maximal inspiratory/expiratory pressure (MIP, MEP), Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were evaluated. Other outcomes included changes in functional capacity and pulmonary function test. We also performed a post-hoc analysis of plasma endothelin-1 levels.
Of 56 randomly assigned patients, 41 were included in the primary final analyses. RMT increased all pulmonary function parameters evaluated and significantly reduced plasma syndecan-1 levels at 8 weeks compared to placebo (between-group difference: −84.5; 95% CI, −148.1 to −20.9). Also, there was a reduction in plasma levels of angiopoietin-2 (between-group difference: −0.48; 95% CI, −1.03 to −0.097). Moreover, there was a significant reduction in mean blood pressure at rest (between-group difference: −12.2; 95%CI, −17.8 to −6.6) associated with a reduction in endothelin-1 levels (between-group difference: −0.164; 95% CI, −0.293 to −0.034). There was no difference regarding biomarkers of endothelial activation or oxidative stress.
A short-term RMT program ameliorate FVC, FEV1 and reduces syndecan-1 and angiopoietin-2 biomarker levels. Finally, better blood pressure control was attained during training and it was associated with a reduction in endothelin-1 levels.
•Muscle Respiratory Training is feasible in hemodialysis patients.•Muscle respiratory Training ameliorates pulmonary function and functional capacity in hemodialysis patients.•Muscle Respiratory Training reduces syndecan-1 and angiopoietin-2 biomarker levels in hemodialysis |
| doi_str_mv | 10.1016/j.rmed.2017.12.005 |
| format | Article |
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This is a randomized controlled clinical trial including 41 patients undergoing thrice-weekly maintenance HD. Patients were randomly assigned at a 2:1 ratio to receive or not RMT during HD sessions for 8 weeks. Main outcomes were changes in levels of the biomarkers related to endothelium activation (vascular cell adhesion molecule 1, VCAM-1, and intercellular adhesion molecule 1, ICAM-1), glycocalyx derangement (syndecan-1), aberrant angiogenesis (angiopoietin-2) and oxidative stress (malondialdehyde) compared to baseline. Also, maximal inspiratory/expiratory pressure (MIP, MEP), Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were evaluated. Other outcomes included changes in functional capacity and pulmonary function test. We also performed a post-hoc analysis of plasma endothelin-1 levels.
Of 56 randomly assigned patients, 41 were included in the primary final analyses. RMT increased all pulmonary function parameters evaluated and significantly reduced plasma syndecan-1 levels at 8 weeks compared to placebo (between-group difference: −84.5; 95% CI, −148.1 to −20.9). Also, there was a reduction in plasma levels of angiopoietin-2 (between-group difference: −0.48; 95% CI, −1.03 to −0.097). Moreover, there was a significant reduction in mean blood pressure at rest (between-group difference: −12.2; 95%CI, −17.8 to −6.6) associated with a reduction in endothelin-1 levels (between-group difference: −0.164; 95% CI, −0.293 to −0.034). There was no difference regarding biomarkers of endothelial activation or oxidative stress.
A short-term RMT program ameliorate FVC, FEV1 and reduces syndecan-1 and angiopoietin-2 biomarker levels. Finally, better blood pressure control was attained during training and it was associated with a reduction in endothelin-1 levels.
•Muscle Respiratory Training is feasible in hemodialysis patients.•Muscle respiratory Training ameliorates pulmonary function and functional capacity in hemodialysis patients.•Muscle Respiratory Training reduces syndecan-1 and angiopoietin-2 biomarker levels in hemodialysis patients.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2017.12.005</identifier><identifier>PMID: 29413495</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aberration ; Adhesion ; Adult ; Aerobics ; Angiogenesis ; Angiopoietin ; Biomarkers ; Biomarkers - blood ; Blood pressure ; Blood Pressure - physiology ; Breathing Exercises - methods ; Cardiovascular disease ; Cell activation ; Cell adhesion ; Cell adhesion molecules ; Chronic obstructive pulmonary disease ; Clinical trials ; Dialysis ; Dyspnea ; Endothelin 1 ; Endothelin-1 - blood ; Endothelins ; Endothelium ; Endothelium - physiopathology ; Evidence-based medicine ; Exercise ; Feasibility studies ; Female ; Fitness training programs ; Forced Expiratory Volume - physiology ; Glycocalix ; Glycocalyx - physiology ; Hemodialysis ; Humans ; Hypertension ; Intercellular adhesion molecule 1 ; Intervention ; Kidney diseases ; Kidney Failure, Chronic - physiopathology ; Kidney Failure, Chronic - therapy ; Male ; Malondialdehyde ; Middle Aged ; Mortality ; Muscles ; Oxidative stress ; Oxidative Stress - physiology ; Patients ; Peritoneal dialysis ; Physical fitness ; Plasma ; Plasma levels ; Pulmonary function ; Pulmonary functions ; Reduction ; Renal Dialysis - adverse effects ; Respiration ; Respiratory function ; Respiratory Function Tests ; Respiratory Mechanics - physiology ; Respiratory Muscles - physiopathology ; Syndecan ; Test procedures ; Training ; Treatment Outcome ; Vascular cell adhesion molecule 1 ; Vital Capacity - physiology</subject><ispartof>Respiratory medicine, 2018-01, Vol.134, p.103-109</ispartof><rights>2017 Elsevier Ltd</rights><rights>Copyright © 2017 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Jan 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-2336a7bb08d80b05c67e804ee3e492260e31d221190023c5e770f9f296dcd5573</citedby><cites>FETCH-LOGICAL-c428t-2336a7bb08d80b05c67e804ee3e492260e31d221190023c5e770f9f296dcd5573</cites><orcidid>0000-0002-0409-6113</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0954611117304158$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29413495$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Campos, Nataly Gurgel</creatorcontrib><creatorcontrib>Marizeiro, Débora Fortes</creatorcontrib><creatorcontrib>Florêncio, Ana Carolina Lins</creatorcontrib><creatorcontrib>Silva, Ítalo Caldas</creatorcontrib><creatorcontrib>Meneses, Gdayllon Cavalcante</creatorcontrib><creatorcontrib>Bezerra, Gabriela Freire</creatorcontrib><creatorcontrib>Martins, Alice Maria Costa</creatorcontrib><creatorcontrib>Libório, Alexandre Braga</creatorcontrib><title>Effects of respiratory muscle training on endothelium and oxidative stress biomarkers in hemodialysis patients: A randomized clinical trial</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Hemodialysis (HD) patients have altered pulmonary function and this is associated with impaired endothelial function and cardiovascular events. Respiratory muscle training (RMT) has the potential to improve cardiovascular outcomes in patients undergoing maintenance HD. Here, we evaluated the effects of RMT on endothelium/glycocalyx, oxidative stress biomarkers and pulmonary function test in HD patients.
This is a randomized controlled clinical trial including 41 patients undergoing thrice-weekly maintenance HD. Patients were randomly assigned at a 2:1 ratio to receive or not RMT during HD sessions for 8 weeks. Main outcomes were changes in levels of the biomarkers related to endothelium activation (vascular cell adhesion molecule 1, VCAM-1, and intercellular adhesion molecule 1, ICAM-1), glycocalyx derangement (syndecan-1), aberrant angiogenesis (angiopoietin-2) and oxidative stress (malondialdehyde) compared to baseline. Also, maximal inspiratory/expiratory pressure (MIP, MEP), Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were evaluated. Other outcomes included changes in functional capacity and pulmonary function test. We also performed a post-hoc analysis of plasma endothelin-1 levels.
Of 56 randomly assigned patients, 41 were included in the primary final analyses. RMT increased all pulmonary function parameters evaluated and significantly reduced plasma syndecan-1 levels at 8 weeks compared to placebo (between-group difference: −84.5; 95% CI, −148.1 to −20.9). Also, there was a reduction in plasma levels of angiopoietin-2 (between-group difference: −0.48; 95% CI, −1.03 to −0.097). Moreover, there was a significant reduction in mean blood pressure at rest (between-group difference: −12.2; 95%CI, −17.8 to −6.6) associated with a reduction in endothelin-1 levels (between-group difference: −0.164; 95% CI, −0.293 to −0.034). There was no difference regarding biomarkers of endothelial activation or oxidative stress.
A short-term RMT program ameliorate FVC, FEV1 and reduces syndecan-1 and angiopoietin-2 biomarker levels. Finally, better blood pressure control was attained during training and it was associated with a reduction in endothelin-1 levels.
•Muscle Respiratory Training is feasible in hemodialysis patients.•Muscle respiratory Training ameliorates pulmonary function and functional capacity in hemodialysis patients.•Muscle Respiratory Training reduces syndecan-1 and angiopoietin-2 biomarker levels in hemodialysis patients.</description><subject>Aberration</subject><subject>Adhesion</subject><subject>Adult</subject><subject>Aerobics</subject><subject>Angiogenesis</subject><subject>Angiopoietin</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Blood pressure</subject><subject>Blood Pressure - physiology</subject><subject>Breathing Exercises - methods</subject><subject>Cardiovascular disease</subject><subject>Cell activation</subject><subject>Cell adhesion</subject><subject>Cell adhesion molecules</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Clinical trials</subject><subject>Dialysis</subject><subject>Dyspnea</subject><subject>Endothelin 1</subject><subject>Endothelin-1 - blood</subject><subject>Endothelins</subject><subject>Endothelium</subject><subject>Endothelium - physiopathology</subject><subject>Evidence-based medicine</subject><subject>Exercise</subject><subject>Feasibility studies</subject><subject>Female</subject><subject>Fitness training programs</subject><subject>Forced Expiratory Volume - physiology</subject><subject>Glycocalix</subject><subject>Glycocalyx - physiology</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Intercellular adhesion molecule 1</subject><subject>Intervention</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - physiopathology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Malondialdehyde</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Muscles</subject><subject>Oxidative stress</subject><subject>Oxidative Stress - physiology</subject><subject>Patients</subject><subject>Peritoneal dialysis</subject><subject>Physical fitness</subject><subject>Plasma</subject><subject>Plasma levels</subject><subject>Pulmonary function</subject><subject>Pulmonary functions</subject><subject>Reduction</subject><subject>Renal Dialysis - adverse effects</subject><subject>Respiration</subject><subject>Respiratory function</subject><subject>Respiratory Function Tests</subject><subject>Respiratory Mechanics - physiology</subject><subject>Respiratory Muscles - physiopathology</subject><subject>Syndecan</subject><subject>Test procedures</subject><subject>Training</subject><subject>Treatment Outcome</subject><subject>Vascular cell adhesion molecule 1</subject><subject>Vital Capacity - physiology</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EotPCC7BAltiwSbj-yY8Rm6pqAakSG1hbjn1DPSTxYDsVwyvw0jiadsOClRf-zrF1PkJeMagZsPbdvo4zupoD62rGa4DmCdmxRvBKQCufkh2oRlYtY-yMnKe0BwAlJTwnZ1xJJqRqduTP9TiizYmGkUZMBx9NDvFI5zXZCWmOxi9--U7DQnFxId_h5NeZmsXR8Ms7k_090pRLNNHBh9nEHxgT9Qu9wzk4b6Zj8okeCohLTu_pJY0lHGb_Gx21U2m3ZirvFPIFeTaaKeHLh_OCfLu5_nr1qbr98vHz1eVtZSXvc8WFaE03DNC7HgZobNthDxJRoFSct4CCOc4ZUwBc2Aa7DkY1ctU665qmExfk7an3EMPPFVPWs08Wp8ksGNakmVKq7bkCVtA3_6D7sMal_E5zgK4RIMVWyE-UjSGliKM-RF-mOGoGelOl93pTpTdVmnFdVJXQ64fqddjuHiOPbgrw4QRg2eLeY9TJlhEtOh-LMu2C_1__X4V4ppE</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Campos, Nataly Gurgel</creator><creator>Marizeiro, Débora Fortes</creator><creator>Florêncio, Ana Carolina Lins</creator><creator>Silva, Ítalo Caldas</creator><creator>Meneses, Gdayllon Cavalcante</creator><creator>Bezerra, Gabriela Freire</creator><creator>Martins, Alice Maria Costa</creator><creator>Libório, Alexandre Braga</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0409-6113</orcidid></search><sort><creationdate>201801</creationdate><title>Effects of respiratory muscle training on endothelium and oxidative stress biomarkers in hemodialysis patients: A randomized clinical trial</title><author>Campos, Nataly Gurgel ; Marizeiro, Débora Fortes ; Florêncio, Ana Carolina Lins ; Silva, Ítalo Caldas ; Meneses, Gdayllon Cavalcante ; Bezerra, Gabriela Freire ; Martins, Alice Maria Costa ; Libório, Alexandre Braga</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-2336a7bb08d80b05c67e804ee3e492260e31d221190023c5e770f9f296dcd5573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aberration</topic><topic>Adhesion</topic><topic>Adult</topic><topic>Aerobics</topic><topic>Angiogenesis</topic><topic>Angiopoietin</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Blood pressure</topic><topic>Blood Pressure - physiology</topic><topic>Breathing Exercises - methods</topic><topic>Cardiovascular disease</topic><topic>Cell activation</topic><topic>Cell adhesion</topic><topic>Cell adhesion molecules</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Clinical trials</topic><topic>Dialysis</topic><topic>Dyspnea</topic><topic>Endothelin 1</topic><topic>Endothelin-1 - blood</topic><topic>Endothelins</topic><topic>Endothelium</topic><topic>Endothelium - physiopathology</topic><topic>Evidence-based medicine</topic><topic>Exercise</topic><topic>Feasibility studies</topic><topic>Female</topic><topic>Fitness training programs</topic><topic>Forced Expiratory Volume - physiology</topic><topic>Glycocalix</topic><topic>Glycocalyx - physiology</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Intercellular adhesion molecule 1</topic><topic>Intervention</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - physiopathology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Malondialdehyde</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Muscles</topic><topic>Oxidative stress</topic><topic>Oxidative Stress - physiology</topic><topic>Patients</topic><topic>Peritoneal dialysis</topic><topic>Physical fitness</topic><topic>Plasma</topic><topic>Plasma levels</topic><topic>Pulmonary function</topic><topic>Pulmonary functions</topic><topic>Reduction</topic><topic>Renal Dialysis - adverse effects</topic><topic>Respiration</topic><topic>Respiratory function</topic><topic>Respiratory Function Tests</topic><topic>Respiratory Mechanics - physiology</topic><topic>Respiratory Muscles - physiopathology</topic><topic>Syndecan</topic><topic>Test procedures</topic><topic>Training</topic><topic>Treatment Outcome</topic><topic>Vascular cell adhesion molecule 1</topic><topic>Vital Capacity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Campos, Nataly Gurgel</creatorcontrib><creatorcontrib>Marizeiro, Débora Fortes</creatorcontrib><creatorcontrib>Florêncio, Ana Carolina Lins</creatorcontrib><creatorcontrib>Silva, Ítalo Caldas</creatorcontrib><creatorcontrib>Meneses, Gdayllon Cavalcante</creatorcontrib><creatorcontrib>Bezerra, Gabriela Freire</creatorcontrib><creatorcontrib>Martins, Alice Maria Costa</creatorcontrib><creatorcontrib>Libório, Alexandre Braga</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Campos, Nataly Gurgel</au><au>Marizeiro, Débora Fortes</au><au>Florêncio, Ana Carolina Lins</au><au>Silva, Ítalo Caldas</au><au>Meneses, Gdayllon Cavalcante</au><au>Bezerra, Gabriela Freire</au><au>Martins, Alice Maria Costa</au><au>Libório, Alexandre Braga</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of respiratory muscle training on endothelium and oxidative stress biomarkers in hemodialysis patients: A randomized clinical trial</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2018-01</date><risdate>2018</risdate><volume>134</volume><spage>103</spage><epage>109</epage><pages>103-109</pages><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Hemodialysis (HD) patients have altered pulmonary function and this is associated with impaired endothelial function and cardiovascular events. Respiratory muscle training (RMT) has the potential to improve cardiovascular outcomes in patients undergoing maintenance HD. Here, we evaluated the effects of RMT on endothelium/glycocalyx, oxidative stress biomarkers and pulmonary function test in HD patients.
This is a randomized controlled clinical trial including 41 patients undergoing thrice-weekly maintenance HD. Patients were randomly assigned at a 2:1 ratio to receive or not RMT during HD sessions for 8 weeks. Main outcomes were changes in levels of the biomarkers related to endothelium activation (vascular cell adhesion molecule 1, VCAM-1, and intercellular adhesion molecule 1, ICAM-1), glycocalyx derangement (syndecan-1), aberrant angiogenesis (angiopoietin-2) and oxidative stress (malondialdehyde) compared to baseline. Also, maximal inspiratory/expiratory pressure (MIP, MEP), Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were evaluated. Other outcomes included changes in functional capacity and pulmonary function test. We also performed a post-hoc analysis of plasma endothelin-1 levels.
Of 56 randomly assigned patients, 41 were included in the primary final analyses. RMT increased all pulmonary function parameters evaluated and significantly reduced plasma syndecan-1 levels at 8 weeks compared to placebo (between-group difference: −84.5; 95% CI, −148.1 to −20.9). Also, there was a reduction in plasma levels of angiopoietin-2 (between-group difference: −0.48; 95% CI, −1.03 to −0.097). Moreover, there was a significant reduction in mean blood pressure at rest (between-group difference: −12.2; 95%CI, −17.8 to −6.6) associated with a reduction in endothelin-1 levels (between-group difference: −0.164; 95% CI, −0.293 to −0.034). There was no difference regarding biomarkers of endothelial activation or oxidative stress.
A short-term RMT program ameliorate FVC, FEV1 and reduces syndecan-1 and angiopoietin-2 biomarker levels. Finally, better blood pressure control was attained during training and it was associated with a reduction in endothelin-1 levels.
•Muscle Respiratory Training is feasible in hemodialysis patients.•Muscle respiratory Training ameliorates pulmonary function and functional capacity in hemodialysis patients.•Muscle Respiratory Training reduces syndecan-1 and angiopoietin-2 biomarker levels in hemodialysis patients.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>29413495</pmid><doi>10.1016/j.rmed.2017.12.005</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-0409-6113</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Respiratory medicine, 2018-01, Vol.134, p.103-109 |
| issn | 0954-6111 1532-3064 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1999682901 |
| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aberration Adhesion Adult Aerobics Angiogenesis Angiopoietin Biomarkers Biomarkers - blood Blood pressure Blood Pressure - physiology Breathing Exercises - methods Cardiovascular disease Cell activation Cell adhesion Cell adhesion molecules Chronic obstructive pulmonary disease Clinical trials Dialysis Dyspnea Endothelin 1 Endothelin-1 - blood Endothelins Endothelium Endothelium - physiopathology Evidence-based medicine Exercise Feasibility studies Female Fitness training programs Forced Expiratory Volume - physiology Glycocalix Glycocalyx - physiology Hemodialysis Humans Hypertension Intercellular adhesion molecule 1 Intervention Kidney diseases Kidney Failure, Chronic - physiopathology Kidney Failure, Chronic - therapy Male Malondialdehyde Middle Aged Mortality Muscles Oxidative stress Oxidative Stress - physiology Patients Peritoneal dialysis Physical fitness Plasma Plasma levels Pulmonary function Pulmonary functions Reduction Renal Dialysis - adverse effects Respiration Respiratory function Respiratory Function Tests Respiratory Mechanics - physiology Respiratory Muscles - physiopathology Syndecan Test procedures Training Treatment Outcome Vascular cell adhesion molecule 1 Vital Capacity - physiology |
| title | Effects of respiratory muscle training on endothelium and oxidative stress biomarkers in hemodialysis patients: A randomized clinical trial |
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