ABREVIATURAS

This report aims to describe the activities developed during a Professional Internship integrated in the Master of Clinical Nutrition, conducted from October 16, 2013 until March 28, 2014 in Niterói, State of Rio de Janeiro (Brazil). This internship was held in three institutions: Ambulatory of Renal Nutrition at School of Nutrition at Federal Fluminense University (UFF), Ward of Medical Clinic and Clinical Research Unit of the University Hospital Antônio Pedro (HUAP). The activities undertaken consisted of nutritional intervention and routine follow-up of patients treated at the Ambulatory of Renal Nutrition of UFF, and hospitalized patients in the Medical Clinic of HUAP, through food and clinical case histories, assessment of anthropometric and biochemical parameters, dietary plans and prescription nutritional guidelines, monitoring of adherence to the diet by patients and their nutritional and clinical evolution. During this period I had the chance to work in two investigations, in which we assessed the effects of a program of strength training in chronic kidney disease patients on hemodialysis by measurement anthropometric parameters and recording food intake. Additionally, we also applied two surveys that assessed dietary intake and factors that affected appetite in these patients, as well as a clinical analysis of biochemical parameters. Moreover, I also developed a research that evaluated the effects of a single session of strength physical exercise on the oxidative stress and inflammation markers response, as well as plasma levels of irisin in chronic kidney disease patients during hemodialysis session; which resulted in two unique articles, awaiting approval for publication. These activities allowed me to develop new skills and gain experience in several fields - renal and hospital nutrition and clinical research - in addition to reinforcing the important role of the Nutritionist in the prevention, recovery or delaying progression of comorbidities. Abstract Introduction and objectives: Strength physical exercise can be a new therapeutic approach to reduce oxidative stress and inflammation in chronic kidney disease patients. The purpose of this study was to assess the effect of acute intradialytic strength physical exercise on the oxidative stress and inflammatory responses in hemodialysis (HD) patients. Methods: Sixteen HD patients were studied (11 women; 44.4 ± 14.6 years; body mass index 23.3 ± 4.9 Kg/m 2 ) and served as their own controls. Acute (single session) intradialytic physical exercise were performed for three sets of ten repetitions for four exercise categories in both lower limbs during 30 minutes. Blood samples were collected on two different days at exactly the same time. Antioxidant enzymes activity [superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)], lipid peroxidation marker levels [malondialdehyde (MDA)] and inflammatory marker [high-sensitivity C-reactive protein (hs-CRP)] were determined. Results : SOD plasma levels were significantly reduced after acute physical exercise from 244.8 ± 40.7 Conclusion: These data suggest that acute intradialytic strength physical exercise was unable to reduce oxidative stress and inflammation, and in addition, it seems to reduce plasma SOD levels, which could to exacerbate the oxidative stress in HD patients. Abstract Introduction and objectives: Irisin is a recently discovered hormone secreted by myocytes during exercise, and irisin stimulates the “browning” of the white adipose tissue. The purpose of this study was to assess the effect of acute strength training on irisin plasma levels in hemodialysis (HD) patients. Methods: Sixteen HD patients were studied (11 women; 44.4 ± 14.6 years; body mass index (BMI) 23.3 ± 4.9 Kg/m 2 ; 61.1 ± 43.1 months of dialysis) and served as their own controls. Acute (single session) intradialytic physical exercise were performed at 60% of the 1-repetition maximum test for three sets of ten repetitions for four exercise categories in both lower limbs during 30 minutes. Blood samples were collected on different days at exactly the same time (30 and 60 min after initiating the dialysis - with and without exercise). Plasma irisin levels were measured using ELISA methods, and anthropometric and biochemical parameters were also evaluated. Results : Irisin plasma levels were significantly reduced after acute physical exercise (125.0  18.5 to 117.4  15.0 ng/mL, p=0.02) and without exercise (from 121.5  13.7 to 115.4  17.2 ng/mL, p=0.02). There was no association between irisin levels and the anthropometric or biochemical parameters. Conclusion: These data suggest that acute strength training was unable to augment plasma irisin levels in HD patients, and the dialysis process may