#1393 The impact of intradialytic physical activity on inflammatory markers in patients with diabetes mellitus

Abstract Background and Aims To evaluate the effect of intradialytic exercise on inflammatory markers in patients with diabetes mellitus. Method The study included 103 patients with stage 5 CKD undergoing program hemodialysis. Of these, 33 patients (32.04%) had diabetes as the main etiological cause. The average age of the patients was 54.79 ± 1.27 years. In all subjects, the activity of lipid peroxidation (LPO) processes was assessed by the concentration of malondialdehyde (MDA), markers of inflammation, endothelium-dependent vasodilation (EDVD), indicators of the antioxidant system (AOS). Results Before the hemodialysis procedure, the concentration of MDA in patients with DM was significantly higher than in patients with other etiologies of CKD (P < 0.05). However, no differences in MDA concentration were observed between the groups at 60–90 minutes and by the end of the HD session. Physical exercise positively influenced inflammatory markers, EDVD, and the balance of LP/AS in patients with DM and those with other etiologies of CKD. Intradialytic PE contributed to a reduction in inflammatory processes and an improvement in endothelial function. Intradialytic vasculopathy at advanced stages of CKD is primarily influenced by universal mechanisms associated with nephrosclerosis and uremia, which offset the differences caused by the underlying disease. Conclusion DM has a limited impact on the development of intradialytic vasculopathy in the context of CKD. This is due to the predominance of uremic and nephrosclerotic pathogenic mechanisms in the advanced stages of the disease. Intradialytic physical exercise demonstrates a pronounced protective effect, improving endothelial function, LP/AS balance, and inflammatory markers regardless of the CKD etiology.

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