OBJECTIVE: To compare the effects of high versus moderate loads of intradialytic resistance training (RT) on body composition, sarcopenia prevalence, functional capacity, inflammatory markers, and quality of life (QoL) in hemodialysis patients. DESIGN: A pilot randomized clinical trial. SETTING: Two hemodialysis centers. PARTICIPANTS: 80 hemodialysis patients (51% of males, aged 30 to 75 years old) in treatment for at least three months, adequately dialyzed (Kt/V >= 1.2), vascular access for arteriovenous fistula. INTERVENTIONS: The 12 weeks intradialytic RT were performed three times per week. The training groups were: high-load intradialytic group (HLG 8 to 10 repetitions), moderate-load intradialytic group (MLG 16 to 18 repetitions), and control group (CG stretching exercise). The total training volume was equalized among training groups. MAIN OUTCOME MEASURES: Leg lean mass assessed by a dual-energy x-ray absorptiometry, functional capacity by short battery physical performance and time and go test, QoL by Kidney Disease QoL instrument, inflammatory markers, and sarcopenia. RESULTS: After the training period, the HLG increased leg lean mass compared with the CG. The HLG also displayed improvements in the pain and physical function domains. The skeletal muscle index and functional capacity increased in both RT protocols. The prevalence of sarcopenia was reduced 14.3% and 25% in the MLG and HLG, respectively, while there was an increase of 10% in the CG. No differences were observed in cytokines after intervention. CONCLUSION: High-load intradialytic RT was associated with gains in leg lean mass and QoL while functional capacity, appendicular muscle mass, and sarcopenia status were improved regardless of the RT load.

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