Anaemia and reduced exercise capacity in patients on chronic haemodialysis

1. In order to evaluate the influence of varying degrees of anaemia on exercise capacity and haemodynamic parameters, 13 patients on chronic intermittent haemodialysis with haemoglobin levels between 5.1 and 12.2 g/100 ml were subjected to an exhaustive exercise test. Measurements during bicycle ergometry consisted of O2 uptake at the anaerobic threshold and of maximum O2 uptake. Resting haemodynamic parameters such as cardiac index, heart rate, stroke volume index and blood pressure were assessed non-invasively in the 13 patients undergoing exercise and in an additional three patients. 2. O2 uptake at the anaerobic threshold as well as maximum peripheral O2 uptake were severely impaired and were positively correlated with haemoglobin concentration. The strongest correlation was found between the impairment of O2 uptake at maximum workload, as assessed by maximum O2 uptake/predicted maximum O2 uptake, and haemoglobin concentration. Haemodynamic alterations in the resting state consisted of a cardiac index in the upper normal range and did not correlate with the haemoglobin concentration. 3. We conclude from our study that exercise capacity in patients on chronic intermittent haemodialysis is severely impaired and that the impairment of aerobic and anaerobic capacity is significantly correlated with the severity of renal anaemia.