Five Months of Physical Exercise in Hemodialysis Patients: Effects on Aerobic Capacity, Physical Function and Self-Rated Health

Abstract

Background: The number of chronic renal failure patients treated by hemodialysis (HD) is continuously increasing. Most patients have reduced physical capacity and have a high risk of cardiac and vascular diseases. The aim of this study was to determine the effects of 5 months physical exercise of HD patients’ physical capacity, self-rated health and risk factors for cardiovascular disease. Methods: 33 HD patients were included in the study. Inclusion criteria: HD for more than 3 months, age >18 years. Exclusion criteria: Diabetes mellitus, symptomatic cardiovascular disease, musculoskeletal limitations, severe peripheral polyneuropathy, inability to speak Danish or English, dementia or other mental disorders. The patients were randomly assigned to an exercise group (EG, n = 22) or a control group (CG, n = 11). Prior to randomization, baseline testing was performed. The effects were measured by aerobic capacity, ‘2-min stair climbing’, ‘squat test’, self-rated health (SF36), blood pressure and lipids. All tests were carried out by blinded testers. The intervention consisted of 1 h of physical exercise twice a week for 5 months. Results: 20 patients completed the intervention. Attendance was 74% of all sessions. There were no dropouts caused by complications related to the intervention. The EG had a significant increase in aerobic capacity, ‘squat test’ and Physical Function and Physical Component Scale (SF36). No significant changes were observed in any of the parameters in the CG. Conclusion: Physical exercise twice a week for 5 months increases physical function and aerobic capacity in HD patients. An exercise program with only two exercise sessions per week seems easy to implement in clinical practice with high attendance among participants. Further investigation is needed to determine the effects on blood pressure and lipids. There were no medical complications related to the exercise program.

Frequent Hemodialysis

“…For example, coupling frequent dialysis with another intervention(s) (e.g., exercise) targeting these contributing physiologic mechanisms may lead to even greater improvements in physical function. We find it particularly interesting that the improvements in both the PHC score and PF score in the FHN trial were similar in magnitude to changes demonstrated previously with exercise interventions (16)(17)(18). There is also notable overlap in the physiologic mechanisms by which exercise and frequent hemodialysis may improve physical function.…”

Exercise training in pediatric patients with end-stage renal disease

“…Being on dialysis requires a lot of time. Physical activity is probably not a first priority for these patients, and thus even exercise training before or after dialysis sessions have been quite unsuccessful [10]. Therefore, all reasons for not completing the program could be attributed directly and indirectly to the underlying illness.…”

ISPD Cardiovascular and Metabolic Guidelines in Adult Peritoneal Dialysis Patients Part I – Assessment and Management of Various Cardiovascular Risk Factors

“…RATIONALE: Physical activity levels are strikingly reduced in patients on dialysis (9). There is overwhelming evidence from observational studies that regular exercise improves physical functioning, exercise capacity, and physical performance and has a favourable influence on metabolic profiles (10)(11). Exercise includes cardiovascular and resistance training, and yoga in various combinations.…”