Effect of blood volume change related to intensity of intradialytic aerobic exercise on hemodialysis adequacy: a pilot study

Usui, Naoto; Uehata, Akimi; Nakata, Jun; Inatsu, Akihito; Tsubaki, Atsuhiro; Saitoh, Masakazu; Izumi, Tomoko; Chiba, Yasuo; Kojima, Sho; Suzuki, Yusuke

doi:10.1007/s11255-021-03038-8

Cited by 1 publication

(8 citation statements)

References 33 publications

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“…13 The heterogeneity between our study and previous studies may be due to the effect of dialysis modality and exercise intensity, and the benefits of IDE for removing small molecules can be quite limited under the current more efficient dialysis conditions. Furthermore, our previous study 13…”

Section: Discussionmentioning

confidence: 77%

“…1 There are studies suggesting that IDEs with AT levels or higher intensities are not beneficial in the removal of UN. 3,13 Moreover, a study conducted using more recent dialysis modality (online haemodiafiltration and dialysis membranes) demonstrated that IDE had only a small effect on the removal of small molecules. 13 The heterogeneity between our study and previous studies may be due to the effect of dialysis modality and exercise intensity, and the benefits of IDE for removing small molecules can be quite limited under the current more efficient dialysis conditions.…”

Section: Discussionmentioning

confidence: 99%

“…This 5‐min break provided a low‐intensity IDE. The 3‐min interval time was determined with reference to BV changes after exercise in a previous study to achieve a certain amount of BV recovery 13 . Both IDE arms had a total exercise time of 45 min.…”

Section: Methodsmentioning

confidence: 99%

“…The 3-min interval time was determined with reference to BV changes after exercise in a previous study to achieve a certain amount of BV recovery. 13 Both IDE arms had a total exercise time of 45 min. Participants completed each trial arm at intervals of after the start of HD, participants started a bicycle exercise in the supine position with the upper body raised by 20 .…”

Section: Intradialytic Exercisementioning

confidence: 99%

“…Moreover, the duration and intensity of exercise can affect changes in BV 11,12 . We previously reported that continuous IDE with intensity greater than the anaerobic threshold (AT), an indicator that can be used in exercise intensity prescriptions based on individual physiological response, may reduce BV and worsen post IDE dialysis efficiency 13 . Therefore, to achieve a more beneficial clinical IDE, it is important to confirm the safety and efficacy in terms of the relationship between exercise intensity and duration and hemodynamics and dialysis efficiency.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of intradialytic continuous and interval training on hemodynamics and dialysis adequacy: A crossover randomized controlled trial

Usui,

Nakata,

Uehata

et al. 2023

Nephrology

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AimCirculating blood volume (BV) during exercise changes depending on the intensity and duration, and post‐exercise hypotension is observed after continuous exercise. We investigated the safety and efficacy of both interval and continuous IDE at anaerobic threshold (AT) levels with respect to hemodynamic stability and dialysis efficiency.MethodsIn this crossover randomized controlled trial, 16 patients on haemodialysis were subjected to three trial arms, including non‐IDE, interval‐IDE, and continuous‐IDE arms. Systolic blood pressure (SBP), BV, and ultraviolet absorbance – an indicator of dialysis efficiency – were continuously measured, and each change was compared between the three arms by two‐way analysis of variance.ResultsContinuous IDE decreased SBP from post‐exercise to the end of dialysis compared with baseline (pre 142.8 ± 19.0 vs. post 127.5 ± 24.5 mmHg, p = .02), whereas interval IDE maintained better SBP levels post‐exercise (pre 139.9 ± 17.1 vs. post 140.1 ± 15.8 mmHg, p = 1.0) than continuous IDE (non‐IDE 133.2 ± 19.9 vs. interval 140.1 ± 15.8 vs. continuous 127.5 ± 24.5 mmHg, p = .04). Moreover, interval IDE caused less tiredness and few symptoms (p < .05), despite reaching higher intensity than continuous IDE (p = .001). The BV of each IDE arm decreased during exercise and recovered post‐exercise to the same level as non‐IDE. Ultraviolet absorbance was not different between each arm (p = .16).ConclusionAT‐level interval IDE maintains better hemodynamic stability from post‐exercise to the end of dialysis and may represent a novel approach that can be effectively performed with fewer symptoms.image

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Section: Discussionmentioning

confidence: 77%