Vanderbilt University Medical Center
Frailty and sarcopenia are modifiable risk factors for morbidity and mortality in patients with ESRD. Exercise is the recommended intervention to prevent frailty and sarcopenia, however, many clinical trials have shown limited clinical improvement in muscle mass and physical function. We propose that mitochondrial dysfunction is one of the deterrents to the effectiveness of the exercise. We plan to evaluate the additive effect of HIIT and CoQ10, a mitochondrial-targeted therapy, on mitochondrial function and physical performance. Understanding the interplay among CoQ10, exercise, and mitochondrial function will identify novel mechanisms to improve the efficiency of exercise. This will also serve to prevent frailty, sarcopenia, and muscle dysfunction in patients with ESRD.
Frailty and sarcopenia in patients with end-stage renal disease (ESRD) Patients on maintenance hemodialysis (MHD) experience frailty and sarcopenia. Approximately 73% of patients are diagnosed with frailty at the time of initiation of dialysis. Frailty is a multisystem impairment associated with vulnerability to stressors, and it is characterized by the presence of three of the following criteria: unintentional weight loss, self-reported exhaustion or fatigue, measured muscle weakness, slow walking speed, and low physical activity. The prevalence of frailty increases with age; approximately 7%…
Inclusion Criteria: * Subjects age 18 to 75 years * On thrice-weekly chronic hemodialysis for at least 6 months (only applicable for patients with ESRD on maintenance hemodialysis). * Clinically stable, adequately dialyzed (single-pool Kt/V \>1.2) thrice weekly, for at least 3 consecutive months prior to the study (only applicable for patients with ESRD on maintenance hemodialysis) Exclusion Criteria: * Body mass index \> 35 mg/kg2 * History of functional transplant less than 6 months prior to study * Use of immunosuppressive drugs within 1 month prior to study * Active connective tissue di…
Participants will receive 1800 mg/day for 12 weeks
Participants will receive placebo or CoQ10/day for 12 weeks
Participants will be performed on non dialysis days. It will be video supervised exercise sessions with self directed exercises using pre-recorded bodyweight and strength exercise videos.
Participant regular activities
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