# Resistance-based exercise restores muscle health in dialysis patients

## TL;DR

Resistance-based exercise improves muscle health in dialysis patients by boosting genes and proteins related to muscle repair and energy production.

## Contribution

This study identifies molecular mechanisms by which resistance-based exercise restores muscle health in dialysis patients.

## Key findings

- Exercise upregulates genes linked to muscle stemness, regeneration, and differentiation.
- Exercise increases mitochondrial proteins involved in oxidation and energy production.
- Exercise enhances glucose uptake and fatty acid metabolism for energy generation.

## Abstract

Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are serious health concerns worldwide that require regular dialysis before a kidney transplant for a better quality of life. Due to aging and frailty, dialysis patients are often limited in physical activity, which can lead to multiple health complications and sometimes result in patient death. Therefore, maintaining muscle health is crucial for individuals undergoing dialysis. We recently reported that personalized resistance-based exercise can improve frailty in dialysis patients; however, the molecular mechanisms underlying its effects on muscle health remain unknown. RNA-Seq analysis revealed that exercise upregulates genes associated with muscle stemness, regeneration, and differentiation. Furthermore, our study demonstrated that exercise upregulates mitochondrial proteins involved in the oxidation of organic compounds and mitochondrial function in muscle. Moreover, we observed that exercise increased energy production via glucose uptake, glycogenesis, and fatty acid metabolism. These results suggest that personalized resistance-based muscle therapy in dialysis patients restores the expression of genes and proteins associated with muscle stemness, regeneration, differentiation, and energy generation.

The online version contains supplementary material available at 10.1007/s10974-026-09727-0.