Intradialytic Exercise on Changes in Blood Pressure in Chronic Kidney Failure Patients during Hemodialysis Therapy

Abstract

Abstract
 BACKGROUND: Chronic renal failure (CRF) is a reduction in chronic renal function that leads to non-reversible and progressive kidney tissue damage. Blood pressure is a major risk factor that can increase the mortality rate by up to 20 times in patients with chronic renal failure who are undergoing hemodialysis therapy. Intradialytic exercise is an intervention that can be used to control systolic blood pressure.
 AIM: This study was to analyze the effect of intradialytic exercise on changes in blood pressure in chronic renal failure patients undergoing hemodialysis therapy at Indriati Solo Baru Hospital.
 METHODS: The research method is quasi-experimental design pre-post with control group design. The study population was 97 dialysis patients. The sampling technique used a purposive sampling of 30 people. Data analysis using Paired t-Test.
 RESULTS: The research results showed that the sex characteristics of most respondents were male as many as 17 people (56.7%), the average age of the respondents was 51.03 years, the pre-intervention in the control group obtained an average systolic blood pressure of 168.93 mmHg and 106 diastole, 120 mmHg, while the blood pressure in the control group post was 173.13 mmHg systole and 107 mmHg diastoles. In the treatment group, the average blood pressure in the pre-intradialytic exercise showed 162.20 mmHg systole and 104.27 mmHg diastole, while the post-intradialytic exercise system blood pressure was 153.13 mmHg and diastole 94.33 mmHg.
 CONCLUSION: There is an effect of intradialytic exercise on changes in blood pressure in chronic renal failure patients undergoing hemodialysis therapy at Indriati Solo Baru Hospital with a p-value of 0.025. Intradialytic exercise can be recommended as structured physical exercise therapy for hemodialysis therapy patients.
 
 KEYWORDS: intradialytic exercise, chronic renal failure, patients, changes in blood pressure, hemodialysis

Effect of Intradialytic Exercise on Cardiovascular Outcomes in Maintenance Hemodialysis: A Systematic Review and Meta-Analysis

“…Studies selected include 18 parallel arm RCTs, two randomized cross-over studies, seven nonrandomized studies that included an intervention and control group, and five single-group pre-post studies. 32 , 47 – 77 In total, 1817 individuals participated in these 32 studies, with sample sizes ranging from 6 to 174 participants (Table 2 ).…”

“… 49 , 52 , 60 , 63 , 67 One study did not state the type of exercise used in the intervention (Table 2 ). 71 …”

“…Most (13 studies) studied predialysis BP measured peripherally using automated BP machines. 47 , 51 , 52 , 57 , 61 – 63 , 66 , 69 , 73 – 76 One study measured interdialytic BP, one study measured BP preintradialytic exercise, two studies measured ambulatory BP (24 and 44 hour), and in three studies, the timing of BP measurement was unclear 50 , 54 , 58 , 59 , 66 , 71 , 77 (Table 4 ).…”

“…67 Attrition ranged from 0% to 61%, with only 4/32 studies reporting no withdrawals. 50,65,71,76 Of 1817 participants in all studies, 367 withdrew (20%). One study did not report attrition.…”

Impact of Pedaling Exercise on Blood Pressure among Patients with chronic Kidney Disease Maintained on Hemodialysis

“…ESRD almost always comes after chronic kidney disease. The kidneys may slowly stop working during a period of 10 to 20 years before endstage disease results (Agustin, et al, 2022 The nephrons in the kidneys are supplied with a group of blood vessels, and high volumes of blood stream through these blood vessels cause uncontrolled hypertension which lead to narrowing, deterioration or coarseness of the arteries that supply the kidney causing decrease in blood supply to kidney, results in kidney failure and CKD (American Heart Association, 2022) Hemodialysis (HD) is one type of renal replacement therapy used in the treatment ESRD to replaces kidney function. HD filters waste, removes extra fluid and balances electrolytes such as sodium, potassium, bicarbonate, chloride, calcium, magnesium and phosphate (Benjamin & Lappin, 2023).…”