Background Intradialytic exercises are recommended to be available as a treatment for enhancing physical functioning. However, there have been few reports which evaluated the results of long-term mild intradialytic exercises in elderly patients. The purpose of this study is to investigate the changes in body weight, body composition, and laboratory data in elderly hemodialysis patients after 1-year intradialytic leg exercises with resistance bands. Methods A retrospective study. Twenty-one outpatients, aged 65 or older (mean ± SD, 75.2 ± 5.1 years), received intradialytic leg exercises with resistance bands for a year were analyzed. The values of dry weight, body composition, and laboratory data were collected from the year-ago period, at baseline and 1 year after baseline. Fat and muscle mass were evaluated by using a multi-frequency bioimpedance device. Results Physical performance changed and body weight increased after 1-year resistance band exercises. However, the participants gained fat mass, not muscle mass. Although the changes in biochemical data related to protein intake were equivocal, triglyceride levels increased significantly after 1-year exercises. An elevation in serum creatinine levels was observed, even if solute clearance increased significantly. Conclusions One-year intradialytic leg exercises with resistance bands may have a potential clinical benefit for body mass index even in elderly hemodialysis patients. However, optimal dietary modification is needed to achieve a balanced increase of muscle and fat mass. An increase of serum creatinine levels does not always mean muscle mass hypertrophy.

<b><i>Background/Aims:</i></b> Malnutrition is a serious complication in dialysis patients that develops slowly but steadily. Cross-sectional studies may not adequately characterize this complication because not only the intensity but longitudinally cumulative effect should also be taken into consideration. Relationship between time-dependent changes in a nutritional marker, Geriatric Nutritional Risk Index (GNRI), and cumulative C-reactive protein (CRP) values was examined whether both intensity and duration of inflammation correlated with time-dependent progression and severity of malnutrition over 3 years, retrospectively. <b><i>Methods:</i></b> One hundred and sixty-four dialysis patients were examined over 3 years retrospectively. Based on analysis of clinical and laboratory findings over a period of 3 years, patients were divided into 2 groups: those with a &#x3e;3.0 decrease in GNRI after 3 years (<i>n</i> = 84) and those in whom GNRI was unchanged (<i>n</i> = 80). <b><i>Results:</i></b> When comparing the 2 groups at 3 years, the GNRI-decreased group had 12% lower serum albumin (<i>p</i> &#x3c; 0.001) and lower levels of creatinine (9%, <i>p</i> &#x3c; 0.001), BUN (6%, <i>p</i> &#x3c; 0.05), total cholesterol (6%, <i>p</i> &#x3c; 0.05), and low-density lipoprotein cholesterol (10%, <i>p</i> &#x3c; 0.01), which suggest onset of malnutrition. CRP levels, routinely measured twice a month in all patients, were summed to calculate the cumulative CRP. Cumulative CRP after 3 years was 57.6 ± 7.8 (mg/dL/3 years) in the GNRI-decreased group, which was significantly higher than that in the GNRI-unchanged group (38.6 ± 3.9; <i>p</i> &#x3c; 0.05). Over 3 years, the GNRI-decreased group showed a time-dependent increase in cumulative CRP alongside a time-dependent decrease in the GNRI, producing an obvious mirror image; however, such inverse correlation was absent in the GNRI-unchanged group. <b><i>Conclusion:</i></b> A long-term perspective is needed in the management of malnutrition in dialysis patients because this complication develops progressively and is often irreversible when diagnosed. Cumulative CRP values may be useful in evaluating the degree of the progression of malnutrition in following up individual patients longitudinally.