Exercise in Patients on Dialysis: A Multicenter, Randomized Clinical Trial.

Area of Science:

• Nephrology
• Exercise Physiology
• Public Health

Background:

• Patients on dialysis often experience reduced functional status and quality of life.
• Physical exercise is increasingly recognized for its potential benefits in managing chronic conditions like kidney disease.

Purpose of the Study:

• To evaluate the effectiveness of a simple, personalized, home-based walking exercise program for adult patients on dialysis.
• To assess the program's impact on physical performance and quality of life over a 6-month period.

Main Methods:

• A 6-month, randomized, multicenter trial involving 296 adult patients on dialysis.
• Participants were assigned to either a normal physical activity control group or a supervised walking exercise group.
• Physical performance was measured using the 6-minute walking test and the five times sit-to-stand test; quality of life was assessed using the KDQOL-SF questionnaire.

Main Results:

• The walking exercise group showed significant improvements in the 6-minute walking test distance (p<0.001) and the five times sit-to-stand test time (p=0.001) compared to the control group.
• Significant improvements were observed in the cognitive function score (p=0.04) and quality of social interaction score (p=0.01) within the kidney disease component of the KDQOL-SF for the exercise group.
• The exercise program was managed by dialysis staff, emphasizing a simple, personalized, and home-based approach.

Conclusions:

• A simple, personalized, home-based, low-intensity exercise program managed by dialysis staff can effectively improve physical performance in patients on dialysis.
• Such exercise interventions may also enhance the quality of life, including cognitive function and social interaction, for this patient population.
• This study supports the integration of supervised exercise into routine dialysis care to improve patient outcomes.