Life In Maintenance Hemodialysis Patients Research Articles

Combined aerobic resistance exercise improves dialysis adequacy and quality of life in patients on maintenance hemodialysis .

This study aims to compare the effect of pure aerobic exercise and combined aerobic resistance exercise on dialysis adequacy and quality of life in patients on maintenance hemodialysis. A total of 45 patients on maintenance hemodialysis were divided into three groups: pure aerobic exercise group, combined aerobic resistance exercise group, and control group. Patients in the control group were only given the usual treatment, which included dietary guidance, drug therapy, and hemodialysis. The other training groups underwent 12-week exercise intervention therapy on the basis of the usual treatment. Blood samples were collected before and after the hemodialysis, at the beginning and end of the intervention for these three groups. Then, the blood urea nitrogen (BUN) concentration was determined, the urea clearance index (Kt/v) and urea degradation rate (URR) were calculated, the dialysis adequacy was evaluated, and the short form-36 (SF-36) scale was used to evaluate the life quality. Before intervention, there was no significant difference in general health condition (GH), Kt/v, URR, SF-36 total score, and the score of each dimension in the three groups. After the intervention therapy, the Kt/v, URR, GH, vitality (VT), and SF-36 total score markedly improved in the pure aerobic exercise group, while the Kt/v, URR, GH, VT, physical functioning (PF), and SF-36 total score significantly increased in the combined aerobic resistance exercise group. Furthermore, compared with the pure aerobic exercise group, the improvement effect of body function (PF score) was better in the combined aerobic resistance exercise group. Both pure aerobic exercise and combined aerobic resistance exercise can significantly improve the dialysis adequacy and quality of life of maintenance hemodialysis patients. Compared with the pure aerobic exercise group, the effect of combined aerobic resistance exercise on PF was better. .

The effect of fine nursing intervention in improving the negative emotion and quality of life of maintenance hemodialysis patients

Objective To explore the effect of fine nursing intervention on improving negative emotion and quality of life in patients with maintenance hemodialysis. Methods A total of 106 cases of maintenance hemodialysis patients who were enrolled in this hospital from February 2017 to February 2018 were randomly divided into control group and observation group according to the random number table method, 53 cases in each group.During hemodialysis, the patients in the control group were given routine clinical nursing interventions for hemodialysis, and the patients in the observation group were given Refined nursing intervention based on routine nursing interventions.The quality of life, adherence to treatment, social support, social avoidance, and distress scores were compared between the two groups before and after intervention. Results Before the nursing intervention, there was no significant difference in KDQOL-SFTM(Kidney Disease and Quality of Life Short Form) scores between the two groups (P>0.05). The KDQOL-SFTM score in the observation group was (65.18±10.57) points, which was higher than that in the control group (59.27±10.24) points, and the difference was statistically significant(P 0.05). The SAS (Self-Rating Anxiety Scale) and SDS (Self-Rating Depression Scale) scores of the two groups after nursing were lower than those before nursing. Compared with the control group, the reduction in the study group was more significant, and the difference was statistically significant (P<0.05). After intervention, SSRS (Social Support Rating Scale) scores of both groups were higher than before intervention, and the study group was higher than the control group, with statistically significant differences (P<0.05). Social Avoidance and Distress Scale scores of both groups were lower than before intervention, and the research group was lower than the control group, with statistically significant differences (P<0.05). Conclusions Refined nursing intervention for patients undergoing maintenance hemodialysis can effectively improve their quality of life, improve treatment compliance, and help patients return to society, which is worthy of clinical promotion. Key words: Maintenance hemodialysis; Refined nursing intervention; Quality of life; Negative emdotion; Social avoidance

Lower urinary tract symptoms impair the quality of life in maintenance hemodialysis patients

BackgroundWith aging, and as the duration of their dependence on dialysis becomes longer, maintenance hemodialysis patients experience decreased urine volume and lose the need to urinate. It is not known whether lower urinary tract symptoms (LUTS) affect the quality of life (QOL) in maintenance hemodialysis patients. We report an observational study that used validated questionnaires to evaluate LUTS and the influence of LUTS on QOL in a group of maintenance hemodialysis patients.MethodsStable patients who were on maintenance hemodialysis were surveyed with the Overactive Bladder Symptom Score and International Prostate Symptom Score, as the disease-specific validated questionnaires for overactive bladder and benign prostatic hypertrophy, to assess the LUTS and with King’s Health Questionnaire to assess the influence of LUTS on QOL.ResultsThis study included 131 patients with a mean age and hemodialysis duration of 69.1 years and 98.1 months. The disease-specific validated questionnaires found that 20 patients of them experienced LUTS. The mean QOL score of King’s Health Questionnaire was significantly impaired (p < 0.01), and hemodialysis duration was significantly shorter (p < 0.01) in the LUTS patients than in the non-LUTS patients. Single and multiple regression analysis showed that LUTS was independently associated with the QOL score of King’s Health Questionnaire (correlation coefficient 0.292; 95% confidence interval 20.36–89.47; p < 0.01).ConclusionsLUTS exists in maintenance hemodialysis patients and impairs the QOL of them assessed with the validated questionnaires. Urological interventions may contribute to improving the QOL of maintenance hemodialysis patients who experiences LUTS.

Relationship between Serum Vitamin D Levels and Health-Related Quality of Life in Maintenance Hemodialysis Patients

Objectives: Aim of the study was investigating the effect of serum vitamin D levels on health-related quality of life in hemodialysis patients. Method: One-hundred and twenty-three maintenance hemodialysis patients were enrolled in this cross-sectional study. Patients divided into 2 groups according to serum vitamin D levels. A serum 25-hydroxyvitamin D (25[OH] D) level of < 20 ng/mL was identified as vitamin D deficiency (n = 78), and a serum level of ≥20 ng/mL was identified as normal (n = 45). Kidney Disease Quality of Life 36 (KDQOL-36) survey was used for quality of life measurement. Scores of the all of 5 subscales of KDQOL-36 were calculated. Multiple linear regression analyses were used to define independent risk factors affecting the survey. Results: Mean age of patients was 62 and 56% of patients were male. Mean 25(OH) D levels were 11.86 and 29.57 ng/mL, respectively, in 2 groups. There was statistically significant difference between age and Kt/V levels between 2 groups (p = 0.008 and p = 0.041). Age and gender were found as significant predictors of vitamin D deficiency (p = 0.026 and p = 0.021). In symptom and problem list subscale, gender and comorbidity were detected as independent risk factors (p = 0.050 and p = 0.032). Comorbidity was the only independent risk factor for effect of kidney disease subscale (p < 0.001). Independent risk factors associated with burden of kidney disease subscale were comorbidity and serum 25 (OH) D levels (p = 0.003 and p = 0.023). Serum 25(OH) D, gender, and comorbidity were independently associated with physical component summary (PCS) subscale (p < 0.001, p = 0.008, and p = 0.011). The only independently associated factor with mental component summary (MCS) was serum 25(OH) D (p < 0.001). Conclusion: We first showed the relationship between serum vitamin D levels and KDQOL-36 in hemodialysis patients. Lower serum vitamin D levels were negatively associated with burden of kidney disease, PCS, and MCS subscales.

Study on correlation between fatigue status and self-management behavior and quality of life in maintenance hemodialysis patients

Objective To explore the relationship between status of maintenance hemodialysis patients, self-management behavior and quality of life, and provide theoretical basis for clinical individualized care and improvement of patients' quality of life. Methods The Fatigue Assessment Instrument (FAI), the self-management scale of hemodialysis patients and the MOS 36-item short-form health survey (SF-36) were used to investigate 140 patients who received long-term hemodialysis treatment in the hospital from June 2014 to June 2016. Results According to the score of FAI rating scale factor 1, there were 45 cases of mild fatigue , 73 cases of moderate fatigue and 22 cases of severe fatigue . There was no significant difference in the total score of self-management behavior between mild fatigue and moderate fatigue patients(P>0.05). The total scores of self-management behaviors, SF-36 physical health and SF-36 mental health of patients with mild fatigue , moderate fatigue and severe fatigue all showed a downward trend, with statistically significant differences (P<0.05). Spearman correlation analysis showed that the factor of maintenance hemodialysis patients were negatively correlated with the total score of self-management behavior, SF-36 physical health score and SF-36 mental health score (P<0.05). Conclusions Fatigue is common in maintenance hemodialysis patients.Severe is not conducive to the maintenance of patients' self-management behavior and can reduce their quality of life. Key words: Hemodialysis; Fatigue; Self-management; Quality of life

Intradialytic exercise training modalities on physical functioning and health-related quality of life in patients undergoing maintenance hemodialysis: systematic review and meta-analysis

Objective: To determine the effects of different intradialytic exercise training modalities on physical functioning and health-related quality of life of maintenance hemodialysis patients. Methods: We searched MEDLINE, Cochrane Trials Register and CINAHL for controlled trials that evaluated the effects of intradialytic exercise training for maintenance hemodialysis patients and published from the earliest available date to December 2017. Weighted mean difference and 95% confidence interval (CI) were calculated, and heterogeneity was assessed using the I2 test. Results: Fifty-six studies met the study criteria, comprising a total of 2586 patients. Compared with no exercise, combined aerobic and resistance exercise resulted in significant improvement in peak VO2 weighted mean difference (5.1 mL kg−1 min−1; 95% CI: 3.4, 6.8 mL kg−1 min−1), depression symptoms (−7.32; 95% CI −9.31, −5.33) and both physical function (10.67 points; 95% CI 1.08, 20.25 points) and vitality (10.01 points; 95% CI 4.30, 15.72 points) domains of health-related quality of life. Resistance exercise alone was significantly associated with improvement in the 6-minute walk test distance (30.2 m; 95% CI 24.6, 35.9 m), knee extensor strength (0.6 N; 95% CI 0.1, 1.0 N) and Physical Component Score of health-related quality of life (9.53 points; 95% CI −3.09, 22.15 points) when compared with control group. Aerobic exercise alone was not significantly associated with aerobic capacity and quality of life improvement. Conclusion: The results provide support to interventions that combine intradialytic aerobic and resistance exercises to improve physical functioning and quality of life in end-stage renal disease patients undergoing hemodialysis.

Effect of nursing intervention on constipation, sleep quality, and quality of life in maintenance hemodialysis patients with constipation

Effect of nursing intervention on constipation, sleep quality, and quality of life in maintenance hemodialysis patients with constipation

Effects of comprehensive care on psychological stress and quality of life in maintenance hemodialysis patients with severe acute pancreatitis

Objective To explore the effects of comprehensive nursing on the psychological stress state and quality of life in patients with severe acute pancreatitis. Methods A total of 90 severe acute pancreatitis patients in the First Affiliated Hospital of Harbin Medical University from January 2011 to January 2013 were randomly admitted to either observation group or control group. The patients of control group adopted routine care model and the patients of observation group received integrated care. The mental state and quality of life of the two groups were evaluated by the Hamilton Anxiety Scale (HAMA) and the concise Health Questionnaire (SF-36). Results After the intervention, two groups of HAMA scale score was significantly improved compared with before treatment, but the degree of the observation group′s improvement was more obvious(P 0.05). The patients of observation group was significantly improved than before treatment, the difference between the two groups was statistically significant (P<0.05). Conclusions The implementation of comprehensive nursing can improve in the mental state and quality of life of patients with severe acute pancreatitis treated by comprehensive nursing mode, and promote the recovery of physical function and improve the curative effect. Key words: Pancreatitis; Hemodialysis; Psychological; Quality of life

Analysis of Factors Affecting Quality of Life in Maintenance Hemodialysis Patients

Analysis of Factors Affecting Quality of Life in Maintenance Hemodialysis Patients

Supervised oral protein supplementation during dialysis in patients with elevated C-reactive protein levels: a two phase, longitudinal, single center, open labeled study.

BackgroundInflammation is considered one of the major causes of protein-energy wasting in maintenance hemodialysis (MHD) patients. It is unclear whether dietary interventions can impact nutritional status and quality of life in MHD patients with elevated C-reactive protein (CRP) levels. Therefore, we examined the hypothesis that supervised intra-dialysis protein supplementation in MHD patients with elevated plasma CRP will improve protein stores and quality of life.MethodsA 24 week, two phase, longitudinal, single center, open labeled study of 50 MHD patients with plasma CRP > 3 mg/L was conducted. During the 12-week observation phase dietary advice was provided to increase protein intake to 1.2 g/kg/day. In the 12-week treatment phase 45 g of liquid protein supplement was provided at each dialysis treatment. Protein nitrogen appearance (PNA), mid-arm muscle circumference (MAMC), serum albumin, body mass index (BMI) and quality of life (assessed by Short Form-12 questionnaire) were measured at baseline, 12 and 24 weeks.ResultsMedian plasma CRP at baseline was 16.0 (IQR 7.7 to 25.1) mg/L. The mean MAMC was 26.5 ± 3.9 cm, BMI 29.2 ± 6.9 kg/m2 and plasma albumin 3.8 ± 0.3 g/dl. During the intervention period, mean PNA increased by 0.13 g/kg/d (p = 0.01) under a mixed effects model. However, there were no clinically or statistically significant effects on MAMC (p = 0.87), plasma albumin (p = 0.70), BMI (p = 0.09), physical (p = 0.32) or mental (p = 0.96) composite scores.ConclusionsIn MHD patients with elevated plasma CRP but otherwise mostly normal nutritional parameters, intra-dialytic oral protein supplement was effective in increasing protein intake but did not provide a detectable impact on nutritional status or quality of life.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-015-0070-0) contains supplementary material, which is available to authorized users.

Effects of omega-3 fatty acids on depression and quality of life in maintenance hemodialysis patients.

Depression and health-related quality of life (HRQoL) are closely interrelated among hemodialysis (HD) patients and associated with negative impacts on patients' clinical outcomes. Considering previous reports on clinical benefits of omega-3 fatty acids in major depression and HRQoL in other patient populations, this study examined effects of omega-3 fatty acids on depression and HRQoL in chronic HD patients. In this randomized placebo-controlled trial, 40 adult patients with a Beck Depression Inventory (BDI) score of ≥16 and HD vintage of at least 3 months were randomized to ingest 6 soft-gel capsules of either omega-3 fatty acids (180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid in each capsule) or corresponding placebo, daily for 4 months. At baseline and after 4 months, 2 questionnaires of BDI and the Medical Outcome Study 36-Item Short-Form Health Survey were completed by each patient. Although baseline BDI score was comparable between the 2 groups, it was significantly lower in the omega-3 group compared with the placebo group at the end of the study (P = 0.008). Except for mental health, social functioning, and general health, other domains of HRQoL showed significant improvement in the omega-3 group compared with the placebo group at month 4 of the study (P < 0.05 for all). Regression analysis revealed that ameliorated BDI score by omega-3 treatment had considerable role in the improvement of overall HRQoL score, physical and mental component dimensions, and score of physical functioning, role-physical, and bodily pain. Supplemental use of omega-3 fatty acids in HD patients with depressive symptoms seems to be efficacious in improving depressive symptoms and HRQoL.

Study on the Clinical Significance and Related Factors of Thirst and Xerostomia in Maintenance Hemodialysis Patients

Aims: To analyse the clinical significance and related factors of thirst and xerostomia and to find methods to alleviate thirst and xerostomia in maintenance hemodialysis (MHD) patients. Methods: Forty-two MHD patients were included for observational study and eleven patients were enrolled for crossover trial. Thirst was assessed by 100-mm visual analog scales (VAS) and dialysis thirst inventory (DTI). Meanwhile, xerostomia was assessed by VAS and xerostomia inventory (XI). Depression, kidney disease quality of life (KDQOL), salivary flow rates and inter dialytic weight gain (IDWG) were measured. Data were analyzed by ANOVA and correlation coefficient was used to assess the correlations between continuous variables. The results of crossover trial were investigated by two-sample T-tests. Results: Strong positive correlations among DTI, VAS thirst score, XI and VAS xerostomia score were found (P=0.000). Daily IDWG was positively correlated with VAS thirst score (r=0.315, P=0.042) and DTI(r=0.391, P=0.010). UWS (unstimulated whole saliva) was negatively correlated with VAS xerostomia score (r=-0.308, P=0.048). Residual urine output was negatively correlated with DTI (r=-0.402, P=0.008), VAS xerostomia score (r=-0.461, P=0.002) and XI (r=-0.403, P=0.008). In the crossover trial, DTI, XI, IDWG2d, IDWG3d, VAS thirst and xerostomia score were significantly reduced by the use of chewing gum (P=0.000, 0.001, 0.009, 0.017, 0.038, 0.001). The VAS thirst score, DTI and IDWG3d were significantly reduced by receiveing straw (P=0.016, 0.003, 0.049). Conclusion: Thirst and xerostomia might affect the quality of life in MHD patients. Both chewing gum and straw could decrease thirst and IDWG.

Relationships between appetite and quality of life in hemodialysis patients

The aim of this paper was to investigate the association between appetite and kidney-disease specific quality of life in maintenance hemodialysis patients. Quality of life (QoL) was measured using the kidney disease quality of life survey. Appetite was measured using self-reported categories and a visual analog scale. Other nutritional parameters included Patient-Generated Subjective Global Assessment (PGSGA), dietary intake, body mass index and biochemical markers C-reactive protein and albumin. Even in this well nourished sample (n=62) of hemodialysis patients, PGSGA score (r=−0.629), subjective hunger sensations (r=0.420) and body mass index (r=−0.409) were all significantly associated with the physical health domain of QoL. As self-reported appetite declined, QoL was significantly lower in nine domains which were mostly in the SF36 component and covered social functioning and physical domains. Appetite and other nutritional parameters were not as strongly associated with the Mental Health domain and Kidney Disease Component Summary Domains. Nutritional parameters, especially PGSGA score and appetite, appear to be important components of the physical health domain of QoL. As even small reductions in nutritional status were associated with significantly lower QoL scores, monitoring appetite and nutritional status is an important component of care for hemodialysis patients.

Peripheral vascular disease severity impacts health outcomes and health-related quality of life in maintenance hemodialysis patients in the HEMO Study

In patients with end-stage renal disease, peripheral vascular disease (PVD) is prevalent. We assessed the extent to which severity of PVD predicts mortality, hospitalizations and health-related quality of life (HRQOL) in hemodialysis (HD) patients enrolled in the Hemodialysis (HEMO) Study. We performed a subanalysis of the HEMO Study, a randomized controlled trial. Adjusted predictors of PVD were analyzed through a multivariable stepwise ordinal logistic model. Relationships between PVD severity and mortality and hospitalizations were determined with Cox proportional hazards models. Relationships between PVD severity and HRQOL were modeled via linear regression and generalized estimating equations. Older age, diabetes, non-African-American race, ischemic heart disease, cerebrovascular disease and longer transplant wait time were associated with more severe PVD. Patients with severe PVD were more likely to suffer from all-cause mortality [hazard ratio (HR) 1.77, 95% confidence interval 1.30-2.40, P<0.001], cardiac death [HR 1.89 (95% confidence interval 1.15-3.11), P=0.001] and infectious death [HR 1.75 (95% confidence interval 1.30-2.34), P<0.001]. Increasing PVD severity was also associated with first cardiac hospitalization or all-cause mortality (P=0.05) and first cardiac hospitalization or cardiac death (P=0.03). HRQOL scores were lower for patients with increasingly severe PVD. These findings underscore the burden of clinically symptomatic PVD in HD patients and its impact on morbidity and mortality. Whether early detection of PVD and prompt initiation of therapy to prevent its progression in the HD population would improve HRQOL and survival outcomes remain to be proven.

The progress of quality of life of maintenance hemodialysis patients

About the research of the quality of life(QOL)of maintenance hemodialysis(MHD)patients, It was well known that the influence factors of quality of life(QOL)of maintenance hemodialysis(MHD)patients were comprehensive, including cognitive factors, disease and treatment factors, cultural factors, social factors, psychological factors, family status, etc. To help patients understand the many factors and seek social and family supports can improve patients' QOL, and correct and timely psychological counseling, drug guidance, effective health guidance can ensure therapeutic effects. Key words: Hemodialysis; Quality of life ; Uremia

Depression and health-related quality of life in maintenance hemodialysis patients

This study was designed to determine the prevalence of depression among hemodialysis (HD) patients from urban hospitals in Korea, to illustrate demographic factors and biomarkers associated with depression and health-related quality of life (HRQOL), and to demonstrate association between depression and HRQOL. For this multicenter, cross-sectional study, 160 HD patients from 3 university teaching hospitals and 3 local dialysis units in Korea were enrolled. Korean Beck's depression inventory and Korean version of Kidney Disease Quality of Life short form, version 1.3 (KDQOL-SFTM 1.3) were used to evaluate depression and quality of life, respectively. Depression was found in 51 out of 160 (31.9%) patients. Old age (> 60 years old), low hemoglobin level (< 10 g/dl), and low economic status were associated with depression, and old age (OR 6.138, p = 0.001) was the most important risk factor among them. Old age, female gender, presence of diabetes mellitus, high comorbidity index score (modified Charlson comorbidity index > or = 6), hypoalbuminemia (< 4.0 g/dl), and high CRP (> 0.5 mg/dl) were common factors associated with decreased HRQOL. Depression and HRQOL showed inverse linear relationship. Moderate to severe depression was common in maintenance HD patients in Korea. Among factors associated with depression and decreased HRQOL, some characteristics are potentially modifiable by social and medical intervention. Further prospective studies are warranted to see whether depression and HRQOL can be improved by modifying these factors.

A study on medical coping style and qualities of life in maintenance hemodialysis patients with alexithymia

Objective To discuss alexithymia in patients with maintenance hemodialysis and its impact on medical coping style and the ability of daily living. Methods The patients with end-stage renal disease treated by the maintenance hemodialysis (MHD) were divided into 2 groups, namely, alexithymia group (total score>60) and non-alexithymia group (total score 60 points ,with an average score (82.37±15.84) and 26 cases for TAS-20 total score <50 points, with an average score (50.17±10.24). There was significant difference (t=8.90, P<0.01). The face factor score of MCMQ was significantly lower in alexithymia groups than that in non-alexithymia group,while the avoidance and subordination factor score was significantly higher than that in non-alexithymia group(P<0.01 or 0.05). The ADL scores and factor scores of the alexithymia group were significantly higher than that of non-alexithymia group,and there was a significant difference (t=3.53, P<0.01). Correlation analysis showed that TAS-20 score and the face factor score of MCMQ was significantly negatively correlated with MCMQ e-vasive and subordination factor,and factor scores and ADL score was significantly positively correlated (P<0.01 or 0.05). Conclusion MHD patients in the alexithymia group tend to use and yield response to avoid negative cop-ing style and less use of active coping style. The quality of life and activities of daily living of MHD patients in alex-ithymia group are worse than that of the non-alexithymia group. Key words: Maintenance hemodialysis; Alexithymia; Medical coping means; ; Daily living ability

The Nutritional and Inflammatory Evaluation in Dialysis patients (NIED) study: Overview of the NIED study and the role of dietitians

The absolute majority of maintenance hemodialysis (MHD) patients die within 5 years of commencing dialysis treatment, mostly because of cardiovascular (CV) disease. The strongest and most common correlates of death in MHD patients are not conventional CV risk factors, but markers of protein-energy malnutrition and inflammation, together also known as malnutrition-inflammation complex syndrome (MICS). Paradoxically, classic risk factors such as obesity and hypercholesterolemia are associated with better survival in MHD patients. It has been hypothesized that this so-called reverse epidemiology is caused by the overwhelming prevalence and dominating effect of MICS in MHD patients. Hence, the key to improving survival and quality of life in MHD patients may be a better understanding of MICS and its interactions with CV disease and outcome. The Nutritional and Inflammatory Evaluation in Dialysis Patients (NIED) study is a longitudinal multicenter cohort study that aims to examine these hypotheses. At any given semiannual round, approximately 360 MHD patients from 8 DaVita dialysis facilities in the Los Angeles area are examined; 900 MHD patients will be cumulatively studied by the end of this 5-year prospective study (October 2001 to September 2006). Repeated measures of markers of nutritional status and inflammation are performed by 10 to 12 dialysis unit dietitians while patients attend their routine HD treatment in their dialysis facilities. All-cause and CV mortality, hospitalization, and quality of life are studied as outcome measures. The collaborating dietitians are the main evaluators and play crucial roles in all aspects of the study. This article reviews the design and infrastructure of the NIED study and reports preliminary findings of the first 12 to 30 months of the study.

EFFECTS OF REGULAR EXERCISE ON ANXIETY, DEPRESSION, AND QUALITY OF LIFE IN MAINTENANCE HEMODIALYSIS PATIENTS

Background: Psychological problems such as depression and anxiety are common in hemodialysis patients. In several studies, exercise programs were effective in relieving depression or anxiety in these patients, although not all agree. Purpose: In this study, we evaluated the effects of an exercise program on exercise capacity, anxiety, depression and quality of life in maintenance hemodialysis patients. Methods: Twenty hemodialysis patients were enrolled in the study. Six patients were later excluded; two due to anemia, one due to nausea with vomiting during exercise, one due to a neurologic problem, and the other two due to noncompliance. Thus, fourteen patients, 3 men and 11 women, aged 42 ± 10 years, completed the study. The exercise program composed of bicycle ergometer, treadmill or upper limb ergometer, 60 min per session, 3 times per week, for 12 weeks. At the beginning and the end of the exercise program, the exercise capacity was determined by measuring the maximal oxygen consumption and exercise duration. In addition, psychological tests for the assessment of depression, anxiety and quality of life were performed. Results: Maximal oxygen consumption was increased from 26.3 ± 4.6 mL/kg/min to 29.8 ± 4.9 mL/kg/min (p = 0.013). Exercise duration was 483 ± 138 s at the start. At the end of the exercise program it was increased to 607 ± 119 s (p = 0.002). The score of anxiety was significantly improved from 47.9 ± 5.9 to 42.8 ± 6.3 after exercise (p = 0.004). Though it did not reach statistical significance there was a trend of improvement in depression (from 44.8 ± 8.4 to 39.7 ± 6.4, p = 0.073). The score of quality of life also showed a significant improvement (from 124.5 ± 16.5 to 133.6 ± 19.3, p = 0.031). Conclusion: The results of this study indicate that an appropriate application of exercise program would improve the psychological status in long-term maintenance hemodialysis patients.