Intradialytic Aerobic Exercise Research Articles

Acute Effect of Intradialytic Aerobic Exercise on Hemodynamic Response, Dialysis-Related Side Effects and Proteome in Patients with Kidney Failure: A Pilot Study

Acute Effect of Intradialytic Aerobic Exercise on Hemodynamic Response, Dialysis-Related Side Effects and Proteome in Patients with Kidney Failure: A Pilot Study

Effects of intradialytic bicycle ergometer exercise on transcription factors NF-ĸB and Nrf2 in patients with chronic kidney disease: A randomized crossover clinical trial

PurposeTo evaluate the effects of an intradialytic aerobic exercise training program on the expression of transcription factors nuclear factor κappa B (NF-κB) and nuclear factor erythroid 2-related factor 2 (Nrf2), related to inflammatory and antioxidant pathways, respectively, in patients with chronic kidney disease (CKD) on hemodialysis. MethodsThis was a longitudinal, randomized clinical trial with a washout period and crossover performed with 33 patients randomized into two groups: Exercise (individualized intradialytic aerobic exercise on an adapted stationary exercise bike) three times per week for three months and control (without exercise). After the washout period (1 month), the exercise group became the control, and the other group performed the exercises for another three months. Blood sample collection, food intake, and anthropometry were evaluated at the beginning and end of each study phase. Nrf2, its target gene NAD(P)H quinone oxidoreductase 1 (NQO1), and NF-κB transcription factors were evaluated by quantitative real-time polymerase chain reaction (qRT-PCR) and the inflammatory cytokines tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) by ELISA assay. ResultsEighteen patients [11 men, 44.1 ± 8.4 years, 17.3 (6.6–124) months on HD] completed all the study. The obtained data revealed that the intervention did not affect Nrf2, NQO1, and NF-κB mRNA expression. Also, TNF-α levels were not changed. However, IL-6 showed a tendency to decrease after the exercise intervention (p = 0.054). ConclusionIn hemodialysis patients, three months of intradialytic aerobic exercise did not modulate the transcription factors associated with inflammation (NF-κB) and antioxidant activity (Nrf2 and NQO1). Clinical trials registration numberNCT04375553.

The Effect of Intradialytic Aerobic Exercise on Dialysis Parameters and Fatigue in Hemodialysis Patients: A Non-randomized Interventional Study.

Introduction Hemodialysis is the standard treatment for end-stage renal disease. However, patients receiving hemodialysis can become less active as a result of treatment, resulting in the accumulation of waste products. Intradialytic exercise improves the clearance of urea and creatinine by opening up vascular beds. Materials and methods We conducted a non-randomized interventional study to evaluate the effect of intradialytic aerobic exercise on dialysis parameters and fatigue among 295 hemodialysis patients selected through consecutive sampling (control group, n=147; experimental group, n=148) from two tertiary care centers. Baseline data on background variables and pre-test dialysis parameters (e.g., blood urea, creatinine, potassium, and hemoglobin levels) were assessed in both groups. Following connection to the hemodialysis machine, participants in the experimental group engaged in 15 minutes of intradialytic aerobic exercise per two hours of dialysis for a total of eight weeks, besides receiving routine care, compared to those in the control group. Post-test dialysis parameters were assessed for both groups at the end of the eighth week. The collected data were analyzed and tabulated using SPSS (IRB Inc., Armonk, New York). Results Intradialytic exercise led to significant improvements in post-test blood urea, creatinine, and fatigue in the experimental group (p<0.001). However, post-test serum potassium and hemoglobin levels remained relatively unchanged. Conclusion This study demonstrates the benefits of intra-dialytic aerobic exercise as a safe complementary therapy for a large population of dialysis patients, leading to better patient outcomes.

Effect of intradialytic aerobic exercise intervention on dialysis adequacy and quality of life in patients with end-stage kidney disease undergoing hemodialysis at Dr. Sardjito General Hospital, Indonesia.

End-stage kidney disease (ESKD) carries a significant financial burden due to the need for hemodialysis (HD). Many HD patients do not achieve optimal dialysis, particularly in developing countries like Indonesia where HD is performed twice a week. To answer this issue, a study was conducted at Dr. Sardjito hospital, Indonesia to investigate the effectiveness of intradialysis aerobic exercise in improving dialysis adequacy and quality of life in conventional HD patients. This study is an experimental design with a pre-test-post-test control group. ESKD with HD patient was divided into treatment and control groups. The intervention group was subjected to 30min of intradialysis aerobic exercise using an ergocycle within the first 2h of the HD sessions, while the control group received regular care. Both groups were followed for 12weeks. Dialysis adequacy is measured using Kt/V and Urea Reduction Ratio (URR). Quality of life is assessed using KDQOL-36 questionnaire. There was a significant increase in Kt/V and URR (%) in the intervention group compared to the control group, (0.122 ± 0.151 vs - 0.135 ± 0.176, p < 0.001) and (2.627 ± 4.634 vs - 2.620 ± 3.949, p < 0.001), respectively. In addition, quality of life also improved significantly with KDQOL-36 summary score was significantly higher 73.47 (39.44-89.31) to 80.97 (43.06-92.36); p = 0.007) in the intervention group. Multivariate analysis showed that intradialysis exercise (p = 0.001), female gender (p = 0.044), and intradialysis diastolic pressure (p = 0.018) can significantly affect Kt/V changes. Intradialytic aerobic exercise for 12weeks effectively improves dialysis adequacy and quality of life in routine HD patients. This suggests an opportunity for routine deployment, especially when HD resources are limited. However, further studies are needed to investigate additional efficacy aspects and improve exercise protocols for specific ESKD patients. TCTR202403270002 (retrospectively registered on March 27, 2024).

The Role of Physical Activity in Improving QOL of Patients Undergoing Hemodialysis

Patients undergoing hemodialysis (HD) experience increased mortality rates and decreased physical activity, which has an impact on patients' low quality of life (QOL). Physical activity has positively affected cardiovascular function, strength, and overall health status. On the other hand, physical activity has not been proven to cause any health hazards in HD patients. However, physical activity has not become a routine practice for HD patients, and there are no clear guidelines for physical activity in HD patients. Due to the inherent condition, intradialytic aerobic exercise appears to be the most suitable physical activity method for HD patients. However, research is still needed to assess the effectiveness and safety of intradialytic exercise (IDE) for HD patients in the long term. Research results can be used as a reference in developing the most appropriate IDE guidelines for HD patients.

An intradialytic aerobic exercise program ameliorates frailty and improves dialysis adequacy and quality of life among hemodialysis patients: a randomized controlled trial.

An intradialytic aerobic exercise program ameliorates frailty and improves dialysis adequacy and quality of life among hemodialysis patients: a randomized controlled trial.

Novel Approach to Intradialytic Progressive Resistance Exercise Training

Physical activity levels are typically undesirably low in chronic kidney disease patients, especially in those undergoing haemodialysis, and particularly on dialysis days. Intradialytic exercise programmes could be a solution to this issue and have been reported to be safe and relatively easily implemented in dialysis clinics. Nevertheless, such implementation has been failing in part due to barriers such as the lack of funding, qualified personnel, equipment, and patient motivation. Intradialytic aerobic exercise has been the most used type of intervention in dialysis clinics. However, resistance exercise may be superior in eliciting potential benefits on indicators of muscle strength and mass. Yet, few intradialytic exercise programmes have focused on this type of intervention, and the ones which have report inconsistent benefits, diverging on prescribed exercise intensity, absent or subjective load progression, equipment availability, or exercise supervision. Commonly, intradialytic resistance exercise interventions use free weights, ankle cuffs, or elastic bands which hinder load progression and exercise intensity monitoring. Here, we introduce a recently developed intradialytic resistance exercise device and propose an accompanying innovative resistance exercise training protocol which aims to improve the quality of resistance exercise interventions within dialysis treatment sessions.

#2559 THE EFFECT OF INTRADIALYTIC EXERCISE ON CARDIAC OUTCOMES IN HEMODIALYSIS PATIENTS

Abstract Background and Aims Cardiovascular disease is the main cause of death of hemodialysis patients, accounting for 42% of all deaths. Because exercise can reduce many risk factors of cardiovascular disease in these patients, we observed the effect of intradialytic exercise on left ventricular structure and function. Method A randomized controlled trial was used. Participants were randomly divided into control group and exercise group. Among them, the exercise group carried out intradialytic aerobic and resistance exercise for 3 months, 5-6 times every two weeks, according to their dialysis frequency. The left ventricular end-diastolic volume, mass and ejection fraction were measured by echocardiography before and 12 weeks after the intervention. (ClinicalTrial registration number: NCT05718765). Results At first, 60 people were recruited and completed the baseline assessment (30 people in each group). The average age of patients in the intervention group was 47.81-11.76 years old, and the average hemodialysis vintage was 17.23-3.09 months. There were 18 men in total. The average age of patients in the control group was 48.56-16.83 years old, and the average hemodialysis period was 17.67-2.83 months. There were 25 men in total. Before the intervention, the two groups of patient indicators were balanced, and the difference was not statistically significant (P&amp;gt;0.05). Finally, 53 patients completed the trial protocol (27 control group and 26 exercise group). After 3 months of intervention, there were significant differences in left ventricular mass, left ventricular end diastolic volume and left ventricular ejection fraction between the two groups (P&amp;lt;0.05). Moreover, the cardiac outcomes of the intervention group were lower than those of the control group, as shown in Table 1. Conclusion The exercise for 3 months can effectively reduce the left ventricular mass and significantly improve the left ventricular function and structure of hemodialysis patients. This will help to improve the research and development of exercise on cardiac in hemodialysis patients.

Nine Months of Hybrid Intradialytic Exercise Training Improves Ejection Fraction and Cardiac Autonomic Nervous System Activity.

Cardiovascular disease is the most common cause of death in hemodialysis (HD) patients. Intradialytic aerobic exercise training has a beneficial effect on cardiovascular system function and reduces mortality in HD patients. However, the impact of other forms of exercise on the cardiovascular system, such as hybrid exercise, is not clear. Briefly, hybrid exercise combines aerobic and strength training in the same session. The present study examined whether hybrid intradialytic exercise has long-term benefits on left ventricular function and structure and the autonomous nervous system in HD patients. In this single-group design, efficacy-based intervention, twelve stable HD patients (10M/2F, 56 ± 19 years) participated in a nine-month-long hybrid intradialytic training program. Both echocardiographic assessments of left ventricular function and structure and heart rate variability (HRV) were assessed pre, during and after the end of the HD session at baseline and after the nine-month intervention. Ejection Fraction (EF), both assessed before and at the end of the HD session, appeared to be significantly improved after the intervention period compared to the baseline values (48.7 ± 11.1 vs. 58.8 ± 6.5, p = 0.046 and 50.0 ± 13.4 vs. 56.1 ± 3.4, p = 0.054 respectively). Regarding HRV assessment, hybrid exercise training increased LF and decreased HF (p < 0.05). Both conventional Doppler and tissue Doppler imaging indices of diastolic function did not change after the intervention period (p > 0.05). In conclusion, long-term intradialytic hybrid exercise training was an effective non-pharmacological approach to improving EF and the cardiac autonomous nervous system in HD patients. Such exercise training programs could be incorporated into HD units to improve the patients' cardiovascular health.

The effect of low-intensity intradialytic aerobic exercise on heart rate variability in maintenance hemodialysis patients

Background: End-stage renal disease (ESRD) patients undergoing maintenance HD typically adopt a sedentary lifestyle which increases cardiometabolic risk and takes many years to be clinically detectable. Heart rate variability (HRV) is a non-invasive method to assess cardiac autonomic modulation. Interventions to increase HRV, such as exercise therapy, have been examined, given the theoretical plausibility that improvements in HRV may lead to improved outcomes. This study aimed at assessing the effects of aerobic exercise during hemodialysis sessions on the HRV of patients with ESRD. Methods: This research is a quasi-experimental study with pre and post-test randomized control group design. From the total of 20 ESRD patients undergoing maintenance HD randomly assigned to either exercise or control group, 2 subjects dropped out, leaving 18 ESRD patients. The patients in the exercise group were submitted to a low intradialytic aerobic exercise, performed during the first two hours of HD, twice weekly, for 12 weeks. At baseline and after 12 weeks, all participants underwent short-(for 5 min) term measurements of HRV. The data were analyzed in the SPSS package program. Results: There is a significant difference in post-pre changes (Δ) SDNN between the exercise and control group, but there were no significant differences in ΔRMSSD (p = 0.157) and ΔLF/HF ratio (p = 0.859), with the large effect size for ΔSDNN (Cohen’s D 1.01), medium effect size for ΔRMSSD (Cohen’s D 0.70), and very small effect size for ΔLF/HF ratio (Cohen’s D 0.09). Conclusion: Twelve weeks of supervised low-intensity intradialytic aerobic exercise has modified heart rate variability in maintenance hemodialysis patients.

Bicycle ergometer exercise during hemodialysis and its impact on quality of life, aerobic fitness and dialysis adequacy: A pilot study

BackgroundChronic kidney disease patients on hemodialysis commonly have a worse quality of life (QoL) due to complications of the disease and dialysis procedure. Physical exercise has emerged as a strategy to improve this scenario. The objective of this study was to evaluate the effect of an intradialytic aerobic exercise program on QoL and aerobic fitness in hemodialysis patients. Material and methodsThese are a secondary analysis of clinical trial data previously published in which hemodialysis patients were randomized into “bike group” (using an adapted exercise bicycle) or “control group” (usual care). The exercise sessions lasted 45 min (5 min of warm-up, 35 min of moderate-intensity and 5 min of cool-down) three times/week for three months. The QoL domains were assessed using the SF-36 QoL questionnaire. Aerobic fitness was evaluated using the 6-min walk test (6MWT). Circulating cytokines, biochemical parameters and Kt/V were also assessed. ResultsNine patients completed three months of exercise (5 men, 44 ± 11 years), and nine were in the control group (6 men, 44 ± 14 years). In the bike group, there was a trend to improve the physical role domain (p = 0.06) regarding QoL, an improvement in the 6MWT (p = 0.02), and in the Kt/V (p = 0.03) after three months. There was a positive correlation between the general health domain and Kt/V (r = 0.691; p = 0.003) and an inverse correlation between the physical functioning domain and plasma TNF-α levels (r = −0.514; p = 0.04). Conclusions12 weeks of intradialytic aerobic exercise was enough to benefit hemodialysis patients' quality of life, aerobic fitness, and quality of dialysis.Clinicaltrials.gov id: NCT04375553.

Effect of intradialytic aerobic cycling exercise on serum TNF-alpha levels in chronic kidney disease patients undergoing regular hemodialysis

article: Effect of intradialytic aerobic cycling exercise on serum TNF-alpha levels in chronic kidney disease patients undergoing regular hemodialysis - Medicina dello Sport 2022 June;75(2):227-37 - Minerva Medica - Journals

Quasi-experimental study to assess the effectiveness of intradialytic aerobic exercises on muscle cramps among patients undergoing haemodialysis in selected hospitals of Pune City

Chronic kidney disease is one of the major non-infectious diseases. Patient with chronic kidney disease mainly requires hemodialysis. Hemodialysis may cause various complications, so the hemodialysis patient requires appropriate care. Aim of the study: Assess the effectiveness of Intradialytic aerobic exercises on muscle cramps among patients Undergoing Hemodialysis. Material and method: The research design adopted for the study was quasi-experimental. 60 patients with chronic kidney disease undergoing hemodialysis were selected by purposive sampling technique. Demographic variables and Muscle cramps scores were assessed among all the patients undergoing hemodialysis. The experimental group received intervention as intradialytic aerobic exercise, and again muscle cramps score was assessed and analyzed. Result: finding of the study, about demographic variables, the majority of the patients were from 35-55 years of age and were graduated. Maximum patients have been diagnosed between 1-3 years and undergone hemodialysis twice a week. Effectiveness was analysed by paired t-test and found Intradialytic aerobic exercises are effective on muscle cramps among patients Undergoing Hemodialysis. There was no association between muscle cramps and demographic variables. Conclusion: The study concluded that intradialytic aerobic exercises effectively reduced muscle cramps in patients undergoing hemodialysis.

The effect of a 6-month intradialytic exercise program on hemodialysis adequacy and body composition: a randomized controlled trial.

End-stage kidney disease (ESKD) is strongly associated with factors that aggravate the physical activity level and body composition status of hemodialysis patients (HD). Even though exercise in HD patients have shown remarkable benefits on hemodialysis adequacy, it is yet inconclusive if exercise can positively affect body composition parameters or if dialysis adequacy may affect body composition status. This study aimed to investigate the effect of a 6-month intradialytic exercise training program on dialysis adequacy indices and body composition parameters in HD patients. A total of 24 HD patients were randomly assigned into two equally sized groups. The exercise group (EX group) participated in a 6-month intradialytic moderate-intensity aerobic exercise training program at the beginning of the HD sessions, three times a week for 60min, and maintained a Borg's Rating of Perceived Exertion score between 13 and 14. The Control group (C group) remained untrained. At baseline, during, and at the end of the 6-month study, we assessed single-pool Kt/V, urea reduction ratio (URR), and body composition parameters, such as extracellular water (ECW)/ intracellular water (ICW) ratio, body mass index (BMI) and lean tissue mass (LTM). In all patients, the 6-min-walking test (6MWT) was performed as a marker of physical performance. A significant increase of both Kt/V (increase by 19%, p = 0.01), and URR (increase by 7%, p = 0.03) values has been observed in the EX group after the 6-month training program. Similarly, a statistically significant increase in 6MWT distance (from 442 ± 67m to 481 ± 68m, p = 0.02) in the EX group has also been found, compared to the C group (from 393 ± 59m to 427 ± 81m, p = 0.06). Neither EX nor C group has shown significant changes in body composition parameters. After training, linear regression analysis revealed a strong positive correlation between Kt/V and 6MWT changes (r = 0.74, p = 0.04) in the EX group. Six months of intradialytic aerobic exercise might increase dialysis adequacy, by increasing Kt/V and URR, and physical performance, regardless of changes in body composition indices.

MO603: Effects of Intradialytic Bicycle Ergometer Exercise on Inflammation Transcription Factors in Patients with Chronic Kidney Disease

Abstract BACKGROUND AND AIMS Oxidative stress and inflammation are involved in the pathophysiological mechanisms in patients with chronic kidney disease (CKD) on hemodialysis (HD). In this context, the therapeutic potential of targeting the gene transcription factors associated with these mechanisms has been studied; for instance, nuclear factor erythroid 2-related factor 2 (Nrf2), the master regulator of antioxidant responses and, nuclear factor κappa B (NF-κB) that promotes the inflammatory response. However, the effects of physical exercise on the modulation of these factors are under investigation in CKD patients. Therefore, the aim of the present study was to evaluate the effects of an intradialytic aerobic exercise training program on the expression of transcription factors (Nrf2 and NF-κB) in patients with CKD on HD. METHODS This is a longitudinal, randomized clinical trial with a washout period and crossover performed with 18 patients randomized into two groups: Exercise (individualized intradialytic aerobic exercise on an adapted stationary exercise bike) three times per week for 3 months and control (without exercise). After the washout period (1 month), the exercise group became the control, and the other group performed the exercises for another 3 months. Peripheral blood mononuclear cells (PBMCs) were isolated, and quantitative real-time PCR analysis was performed to evaluate Nrf2, NF-kB and NAD(P)H: quinone oxidoreductase-1 (NQO1) mRNA expression. The plasma levels of inflammatory cytokines, tumour necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6) were evaluated by ELISA. RESULTS Eighteen patients [11 men, 44.1 ± 8.4 years, 17.3 (6.6–124) months on HD] completed all the study. The obtained data revealed that the intervention did not affect the mRNA expression of Nrf2, NQO1 and NF-κB (Table 1). Also, TNF-α levels were not changed. However, IL-6 showed a tendency to decrease after the exercise intervention (P = 0.054). CONCLUSION Three months of intradialytic aerobic exercise were insufficient for modulating the transcription factors associated with antioxidant activity (Nrf2 and NQO1) and inflammation (NF-κB) in patients with CKD.

The effect of intradialytic aerobic training on physical performance and quality of life among hemodialysis patients

Background Patients with chronic kidney disease and end-stage kidney disease have reduced physical performance and impaired quality of life. The aim of this work is to study the effect of intradialytic aerobic training using a pedal on physical performance and quality of life among hemodialysis (HD) patients. Patients and methods This experimental study was conducted on 30 adult patients with end-stage kidney disease on maintenance HD for more than 3 months. Mentally or physically unfit patients, patients with overt ischemic heart disease or cardiac decompensation, severe anemic patients (hemoglobin≤8 g/dl), patients with advanced chronic kidney disease-mineral and bone disorder, patients with advanced lower limbs joints disease, and those with amputation of the lower limb were excluded. Patients were divided into two groups; each group consisted of 15 patients. Group A performed intradialytic aerobic exercise for 30 min three times/week for 8 weeks. Group B was a control group. Results There was significant improvement in the distance walked in 6-min walk test in the exercise group (P=0.04). Moreover, there was significant improvement in the main scales of kidney disease quality-of-life short form, version 1.3, Arabic version (Kidney Disease Component Summary, Physical Composite Scale, and Mental Composite Scale) (P&lt;0.001, P=0.018, and P=0.037, respectively). Conclusion Exercise has a beneficial effect on the physical performance and quality of life in HD patients.

An intradialytic aerobic exercise program ameliorates frailty and improves dialysis adequacy and quality of life among hemodialysis patients: a randomized controlled trial.

BackgroundHemodialysis patients with chronic kidney disease exhibit impaired exercise tolerance and functional decline. Despite the life-saving benefits of adequate dialysis, those declines translate into frailty and deteriorating quality of life (QoL). This study evaluated the effects of an intradialytic aerobic exercise program on frailty, dialysis adequacy, and QoL among hemodialysis patients. MethodsPatients at an university hospital-affiliated hemodialysis center were randomly assigned to an exercise group (n = 18) or a control group (n = 21). The 12-week aerobic exercise program comprised 40 to 70 minutes of ergometer cycling 3 times/wk and a single education session. The control group completed only the education session. Outcomes were assessed at the time of enrollment, week 4, week 8, and week 12 using Fried’s frailty phenotype measures (gait speed, grip strength, vitality, body mass index, and physical activity), the short physical performance battery (SPPB), Kt/V urea, and the Short Form-36 questionnaire.ResultsThere were significant interactions between groups and follow-up times in the frailty score (p < 0.001), gait speed (p < 0.001), SPPB (p < 0.001), and mental QoL (p = 0.03). The intention-to-treat and per-protocol analyses revealed that the exercise group exhibited significant improvements in frailty score (p < 0.001), gait speed (p < 0.001), grip strength (p < 0.001), exhaustion (p = 0.02), SPPB (p = 0.01), dialysis adequacy (p = 0.01), and physical QoL (p = 0.003).ConclusionAn intradialytic aerobic exercise program could be a safe, feasible, and appropriate additional strategy to routine care among hemodialysis patients for improvements in frailty, dialysis adequacy, and QoL.

Effect of Intradialytic Aerobic Exercise on C-Reactive Protein End Stage Renal Disease Patients

Background: Patients with end-stage renal disease (ESRD) have a high baseline level of systemic inflammation. Serum C-Reactive Protein is an inflammatory marker that is widely used because it is more affordable and available in most hospitals in developing countries. Patiens with ESRD tend to be less involved in physical activity when compared to sedentary patients in the same age group. The effect of intradialytic aerobic exercise on CRP levels has been widely studied, but the result studies about intradialytic aerobic exercise on CRP are still controversial. Objectives: To evaluate the effect of a 12-week intradialytic aerobic exercise program on serum CRP levels in ESRD at the Hemodialysis Installation of Dr. Soetomo Hospital, Surabaya Methods: The study was conducted from March to June 2021. Twenty-six ESRD patients divided into treatment and control groups were able to follow the study until the end. The treatment group did a low-intensity intradialytic exercise program for 12 weeks. Both groups were given education about inflammation in ESRD patients and continued drug therapy and diet as before. Serum CRP was checked before and after intervention. Results: There was a decrease in the mean CRP after the intervention, from 0.33 ± 0.33 to 0.27 ± 0.16 mg/dL but was no significant difference statistically (p=0.543) and the control group (p=0.08) and between the two groups (p=0.960). Conclusion: Intradialytic aerobic exercise has no effect on serum levels of C-reactive protein in end-stage renal disease patients

An Experimental Study to Assess the Effectiveness of Aerobic Exercise on Blood Urea in Hemodialysis Patients in Selected Hospitals, Chennai

Aim: This study was aimed to determine the effect of intradialytic aerobic exercise on blood urea in hemodialysis (HD) patients. Introduction: HD is one way to treat advanced kidney failure and can help to carry on an active life despite failing kidneys. Intradialytic exercise (IDE) is the exercise training performed during the HD session to increase the patient’s strength and endurance. Materials and Methods: A quasi-experimental study was carried out among 60 adult patients on HD (30 each in control and experimental groups), selected by consecutive sampling technique, at selected tertiary care centers in Chennai. The baseline characteristics and pretest blood urea were collected from both the groups and the intradialytic aerobic exercise was administered for 8 weeks (3 times/week) among the experimental group of patients. Then Post-test I and II blood urea were assessed in both the groups at end of 4th and 8th week. The data were analyzed in SPSS 22. Results: IDE showed a significant effect in reducing blood urea (mg/dl) among experimental group of participants than control group in post-test I (76.73 ± 17.58, 93.20 ±19.24) and in post-test II (62.23 ± 13.28, 90.20 ±19.60) at P = 0.001. There was no significance difference in baseline data/pre-test between experimental and control group pre-test (103.53 ± 30.03, 103.70 ± 30.46). Conclusion: This study reveals that intra dialytic aerobic exercises is beneficial in terms of reducing blood urea, as a supplementary therapy for HD patients.

The effect of intradialytic exercise on inflammatory markers in hemodialysis patients

BackgroundChronic low-grade inflammation is a feature of chronic kidney disease associated with increased risk of multiple morbidities and mortalities. Hemodialysis (HD) patients lead a sedentary life style which may aggravate their inflammatory state and practicing exercise may improve this condition. The aim of this work was to study the effect of intradialytic exercise (IDE) on inflammatory markers in HD patients.ResultsThis prospective cohort study included 40 HD patients, divided into 2 groups: exercise group completed IDE for 3 months and non-exercise group matched in age and sex as controls. At baseline, there was no difference between both groups regarding physical performance assessed using short physical performance battery test (SPBT) or inflammatory markers C-reactive protein (CRP) and interleukin 6 (IL-6) P > 0.05. After 3 months, SPBT significantly improved in exercise group (P < 0.001). Also, both serum CRP and IL-6 levels showed significant decrease in exercise group compared to baseline (P < 0.001), while no similar change was noticed in non-exercise group.ConclusionsRegular intradialytic aerobic exercise program can improve physical function and inflammation in hemodialysis patients. Further studies on larger number of patients are warranted.