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Benefits of exercise training during hemodialysis sessions: a prospective cohort study
Adelina Mihaescu1, Claudiu Avram, Flaviu Bob
1Nephrology Department, 'V. Babes' University of Medicine and Pharmacy, Timisoara, Romania.
Insights
Exercise during dialysis improves cardiovascular health in patients with end-stage renal disease. Three months of training reduced arterial stiffness and enhanced body composition and physical performance.
Area of Science:
- Nephrology
- Cardiology
- Sports Medicine
Background:
- Patients with end-stage renal disease (ESRD) face significant cardiovascular risks.
- Cardiovascular complications are a leading cause of mortality in ESRD patients undergoing hemodialysis.
Purpose of the Study:
- To investigate the impact of a 3-month exercise training program during hemodialysis on cardiovascular risk factors.
- To assess changes in arterial stiffness, body composition, and physical performance in chronic hemodialysis patients.
Main Methods:
- A prospective cohort study involving 35 chronic hemodialysis patients (19 intervention, 16 control).
- The intervention group performed 40-minute exercise sessions during each hemodialysis treatment for 3 months.
- Measurements included arterial stiffness (aortic pulse wave velocity, augmentation index, return time, blood pressure), body composition (bioimpedance), and physical performance (hand dynamometer, jump test).
Main Results:
- Exercise training significantly reduced aortic pulse wave velocity (PWV) by 1 m/s and central systolic blood pressure by 10 mm Hg.
- Improvements were observed in arterial return time (increased by 12 seconds), skeletal muscle mass, and soft lean mass.
- Physical performance enhanced, with increased jump height (1 cm), lower limb explosive power (3 W/kg), and handgrip strength (0.06 bar).
Conclusions:
- Exercise training during hemodialysis positively impacts arterial stiffness in ESRD patients.
- The intervention also leads to significant improvements in body composition and physical performance metrics.
- This suggests exercise is a viable strategy to mitigate cardiovascular risk in this population.
Background:
End-stage renal disease patients can be considered as 'cardiovascular time bombs' due to their tremendous cardiovascular risk. Our study has determined the impact of 3 months of exercise training during dialysis on some of the cardiovascular risk factors (arterial stiffness, body composition and physical performance) in a chronic hemodialyzed population.
Methods:
The study group (n = 19) and control group (n = 16) of chronic hemodialysis patients from Timisoara, Romania, were enrolled in a prospective cohort study. The intervention--40 min of exercise training (with non-fistula hand and both lower limbs) during each hemodialysis session for 3 months--was applied only to the study group. The measurements made before and after intervention were aortic pulse wave velocity (PWV), aortic augmentation index, return time and both central and peripheral blood pressure for arterial stiffness evaluation, using the Arteriograph Tensiomed system, body composition by multifrequency bioimpedance and physical performance (Myotest PRO system and hand dynamometer).
Results:
We found a significant 1-m/s reduction in PWV, a 12-second increase in return time and a 10-mm Hg reduction in both central and systolic blood pressure driven only by the exercise training. Exercise training significantly increased the skeletal muscle mass and the soft lean mass of the study group patients. Physical performance significantly improved in the study group jumping height by 1 cm, lower limbs explosive power by 3 W/kg and non-fistula hand strength prehension by 0.06 bar.
Conclusions:
Exercise training during dialysis has a positive effect on arterial stiffness, body composition and physical performance of chronic hemodialyzed patients.
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