Intradialytic exercise may improve patient survival rates in patients receiving hemodialysis

1. Intradialytic exercise for a minimum of 60 minutes during thrice weekly dialysis sessions improved survival rates in adult patients who are receiving hemodialysis (HD).

Evidence Rating Level:1 (Excellent)

Chronic kidney disease is becoming increasingly prevalent worldwide, leading to an exponential increase in the number of individuals experiencing kidney failure requiring kidney-replacement therapy (KRT), which is primarily achieved through hemodialysis. Patients undergoing HD experience high rates of morbidity, and a mortality rate 10-30 times higher than those with normal kidney function. Low physical activity resulting from comorbidities, reduced physical function, decreased aerobic capacity, inactivity during HD sessions, and post-dialysis fatigue, plays a major role in the poor outcomes experienced by HD patients. Therefore, this study aimed to evaluate the effects of intradialytic exercises on HD patient survival and clinical outcomes associated with survival. 74 patients aged ≥ 18 years, receiving regular HD 3 times a week and HD for at least 1 year, were randomized to either the intervention, concurrent 60 minutes of intradialytic exercise during the 2nd hour of dialysis for 6 months, or the control that received usual care. 2 participants in the intervention group and 9 participants in the control group died. The cumulative survival rate in the control group was significantly lower than that in the intervention group (Log rank statistics = 6.5, P = 0.01). In terms of secondary outcomes, the intervention group demonstrated increased serum albumin, hemoglobin, red blood cell count, serum calcium, physical function (6MWT), and nutritional status (GNRI), while the control group’s levels remained mostly unchanged. Overall, the study showed that intradialytic exercise for 6 months improved the survival and certain laboratory parameters of adult patients receiving HD for 12 months. Though further studies are warranted, intradialytic exercise may be a promising adjunctive lifestyle modification for patients with end-stage renal disease.

Click to read the study in BMC Nephrology

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