Home-based exercise and bone mineral density in peritoneal dialysis patients: a randomized pilot study

Abstract

Background The prevalence of osteopenia and osteoporosis is higher in patients with chronic kidney disease than that in the general population. Although physical exercise prevents bone loss in hemodialysis (HD) patients, previous studies have not focused on peritoneal dialysis (PD) patients. Therefore, we aimed to evaluate the effects of home-based exercise on bone mineral density (BMD) in patients with PD. Methods Stable outpatients undergoing PD were randomly assigned to the intervention group (n = 26; male, 20; median age, 66 years) or usual-care group (n = 27; male, 21; median age, 64 years). Patients in the intervention group performed home-based exercises (resistance exercise, stretching, and aerobic exercise such as walking) for 6 months, whereas those in the usual-care group performed stretching and their usual physical activity. Based on dual X-ray absorptiometry, the primary outcomes were the BMD data of the lumbar spine and proximal femoral neck. Secondary outcomes included physical function and physical activity. Pre- and post-intervention values were compared. Results There was no significant within-group change in the BMD of the lumbar spine, femoral neck, and hip after 6 months of the exercise program. The intervention group had significantly improved 30-s chair-stand test, 6-min walk test, and physical activity results. Conclusions Home-based exercises in patients with PD did not improve BMD at any of the sites evaluated. Improvement in physical function and physical activity may reduce the risk of falls in patients with PD. Trial registration UMIN Clinical Trials Registry, UMIN000041678. Registered September 4, 2020; retrospectively registered.

"The effect of Exercise during hemodialysis on serum levels of Albumin, calcium, phosphorus and parathyroid hormone: a randomized clinical trial"

“…On the other hand, the present's results are in line with the results obtained by Tayebi et al (2018) who showed that exercise during hemodialysis had no significant effect on serum levels of Albumin in intervention group [11]. The results of the present study are not in line with the results the study by Watanabe et al (2021), that showed homebased exercise could not significantly affect serum levels of Albumin, Calcium and phosphate [16]. The reason for this difference is maybe the use of different intervention methods and the difference in the duration of the exercise (6 months compared to 8 weeks).…”

The effect of exercise during hemodialysis on serum levels of albumin, calcium, phosphorus and parathyroid hormone: a randomized clinical trial

“…Furthermore, the results of our study are in line with the findings obtained by Kopple et al, who observed that exercise during hemodialysis had no significant effect on serum levels of albumin in the patients of the intervention group (11). The findings of the present research are not in line with the findings of Watanabe et al, where home-based exercise could not significantly affect serum levels of albumin, calcium and phosphate (16). This difference may be related to the use of different exercise programs and the difference in the duration of the exercise (six months compared to eight weeks).…”

Exercise or physical activity-related adverse events in people receiving peritoneal dialysis: A systematic review

“…28 Koufaki et al 29 Manfredini et al 12 Molsted at al. 20 Luo et al 32 Rouchon et al 19 Shahgholian et al 25 Sheshadri et al 31 Uchiyama et al 26 Watanabe et al 27 Lo et al 22 Straub et al 13 Musculoskeletal adverse events were the most frequent accounting for 14 (47%) of 32 reported intervention-related adverse events. This finding is not unexpected as these events account for the majority of adverse events resulting from exercise and physical activity in both healthy and chronic disease populations.…”

“…From the 11, 2 studies 19,20 (8%) provided data upon request, 1 study 13 (4%) did not respond to a request for data however reported withdrawal data were accepted in lieu of adverse event data and 8 studies did not respond to requests for adverse event data (and did not have reported withdrawal data that could be used in lieu). Eight studies [21][22][23][24][25][26][27][28] (32%) reported full adverse event data in-text; four studies 12,[29][30][31] (16%) provided partial adverse event data in-text, with authors providing further data and/or clarification on request, two studies 32,33 (8%) reported partial adverse event data in-text, but did not provide additional details on request to enable proper classification. This resulted in 17 studies being included in the final review.…”

“…mattress, sleep hygiene, etc.). 33 Four studies [22][23][24]29 reported dialysate in the peritoneal cavity during exercise, one study encouraged participants to exercise with dialysate but to drain if uncomfortable, 27 one study did not discourage participants from exercising with dialysate 28 and one study 21 advised participants to drain the dialysate prior to exercise. Ten studies did not report if exercise or physical activity was completed with or without dialysate in the peritoneal cavity.…”