DIFFERENCES OF IL-6 AND HS-CRP LEVELS AND BLOOD PRESSURE IN ROUTINE HEMODIALYSIS CKD PATIENTS UNDERGOING INTRADIALYTIC AEROBIC CYCLING EXERCISE

Dendy Raharjo, Agung Susanto, Bayu Basuki Wijaya, Eti Poncorini Pamungkasari

Abstract

Introduction: CKD patients receiving haemodialysis (HD) therapy may experience worsening of their condition due to inflammation from various causes. Intradialytic aerobic exercise plays a role in minimizing this inflammation. This study aimed to examine the effect of intradialytic aerobic exercise on IL-6 and hs-CRP levels as markers of inflammation as well as its effect on blood pressure in patients who routinely undergo HD.

Methods: This study was a double-blinded randomized control trial (RCT) with a control group and a treatment group that received intradialytic aerobic exercise interventions for 12 weeks; the dose for each session was 30 min at a frequency of 2 times per week. Blood pressure data and blood samples were collected for IL-6 and hs-CRP examination using the enzyme-linked immunosorbent assay (ELISA) method before treatment in the first week and after the last treatment in the 12th week. Statistical analysis was performed using the t-test and regression test.

Results: The mean of systolic blood pressure (SBP) and diastolic blood pressure (DBP) values of the treatment group were not significantly different from the control group (146.15 + 18.39 mmHg vs 153.77 + 31.25 mmHg; p = 0.613 and 94.62 + 14.78 mmHg vs 86.69 + 12 .06 mm Hg; p= 0.089). The mean post-treatment SBP decreased insignificantly (from 150.77 + 24.43 to 146.15 + 18.39; p = 0.438). The mean post-treatment DBP experienced a non-significant increase (from 89.23 + 22.24 to 94.62 + 14.78; p = 0.272). IL-6 and hs-CRP levels in the treatment group were lower when compared to the control group (4.04 + 1.48 pg/ml vs 4.79 + 3.58 pg/ml; p= 0.612 and 17.47 + 23 .59 pg/ml vs 21.79 + 21.97 pg/ml; p=0.596). The mean of post-treatment IL-6 and hs-CRP levels were not significantly higher when compared to before treatment (4.04 + 1.48 pg/ml vs 3.90 + 1.35 pg/ml; p= 0.671 and 17.47 + 23.59 pg/ml vs 8.82 + 7.65 pg/ml; p= 0.297). Neither IL-6 nor hs-CRP affects SBP or DBP.

Conclusion: Intradialytic aerobic exercise for 12 weeks did not significantly affect IL-6, hs-CRP, SBP, or DBP.

Keywords

Chronic kidney disease; hemodialysis; IL-6; hs-CRP; intradialytic aerobic cycling exercise.

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References

Ayoub I, Nelson J, Rovin B. Induction Therapy for Lupus Nephritis: the Highlights. Current Rheumatology Reports. 2018;20(10).

Almaani S, Prokopec S, Zhang J, Yu L, Avila-Casado C, Wither J et al. Rethinking Lupus Nephritis Classification on a Molecular Level. Journal of Clinical Medicine. 2019;8(10):1524.

Atmoko W, Purwanto B, Sugiarto S. Pengaruh Terapi N-Asetil Sistein Terhadap Ekspresi Interleukin 17 dan Fibrosis Interstisial pada Mencit Nefritis Lupus. Biomedika. 2018;9(2).

Wilson P, Kashgarian M, Moeckel G. Interstitial inflammation and interstitial fibrosis and tubular atrophy predict renal survival in lupus nephritis. Clinical Kidney Journal. 2017;11(2):207-218.

Perawatan Luka. 1st ed. Jakarta: Sagung Seto; 2004.

Jayanthi S, Koppolu B, Nguyen K, Smith S, Felber B, Kumar T et al. Modulation of Interleukin-12 activity in the presence of heparin. Scientific Reports. 2017;7(1).

Xu X, Rao G, Quiros R, Kim A, Miao H, Brunn G et al. In Vivo and Vitro Degradation of Heparan Sulfate (HS) Proteoglycans by HPR1 in Pancreatic Adenocarcinomas. Journal of Biological Chemistry. 2007;282(4):2363-2373.

Masola V, Zaza G, Onisto M, Lupo A, Gambaro G. Impact of heparanase on renal fibrosis. Journal of Translational Medicine. 2015;13(1).

Rachmawati A, Purwanto B, Prasetyo D. Pengaruh Pemberian N-Asetilsistein terhadap Ekspresi Caspase-1 Glomerulus dan Derajat Kerusakan Ginjal pada Mencit Nefritis Lupus Induksi Pristan. Biomedika. 2018;10(2).

Purwanto B, Hermawan A, Yogyantoro R, Alsagaff J. Kajian Ekspresi TGF- 1, MMP-9, Kolagen Tipe-I, Kolagen Tipe-IV, Glomerulosklerosis, Interstisial Fibrosis, Albuminuri pada Kejadian Nefrotoksik Doxorubicin dan Nefroprotektif Pentoxifyllin dengan Hewan Coba Mencit Galur Swiss Jantan. Journal Unair. 2011;13(2):78-93.

Loeffler I, Wolf G. Transforming growth factor- and the progression of renal disease. Nephrology Dialysis Transplantation. 2013;29(suppl 1):i37-i45.

Harti S. Biopreparasi Lendir Bekicot (Achatina fulica) menggunakan Membran Kitosan sebagai Kassa Pembaut untuk Penyembuhan Luka. Pendidikan Biologi FKIP UNS. 2015.

Dreyfuss J, Regatieri C, Jarrouge T, Cavalheiro R, Sampaio L, Nader H. Heparan sulfate proteoglycans: structure, protein interactions and cell signaling. Anais da Academia Brasileira de Ciências. 2009;81(3):409-429.

Ferreras L, MoSLE A, Situmorang G, el Masri R, Wilson I, Cooke K et al. Heparan sulfate in chronic kidney diseases: Exploring the role of 3-O-sulfation. Biochimica et Biophysica Acta (BBA) - General Subjects. 2019;1863(5):839-848.

Korf-Klingebiel M, Reboll M, Grote K, Schleiner H, Wang Y, Wu X et al. Heparan Sulfate–Editing Extracellular Sulfatases Enhance VEGF Bioavailability for Ischemic Heart Repair. Circulation Research. 2019;125(9):787-801.

Purnasari P, Fatmawati D, Yusuf I. Pengaruh Lendir Bekicot (Achatina fulica) terhadap Jumlah Sel Fibroblas pada Penyembuhan Luka Sayat Studi Eksperimental pada Kulit Mencit (Mus musculus). Sains Medika. 2012;4(2).

Robbins. Buku Ajar Patologi. Edisi 7. Jakarta: Penerbit Buku Kedokteran EGC; 2007.

DOI: https://doi.org/10.20961/tscm.v1i2.86053

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