Structured exercise improves vascular access and functional outcomes in hemodialysis patients: a randomized...

Area of Science:

• Nephrology and Exercise Physiology
• Vascular Biology and Access Management

Background:

• Vascular access complications are a significant cause of morbidity in patients undergoing maintenance hemodialysis (HD).
• While exercise improves cardiovascular and functional outcomes in HD patients, its effect on vascular access parameters is not well understood.

Purpose of the Study:

• To evaluate the impact of a 12-week structured exercise program on vascular access diameter, physical function, depression, and quality of life in HD patients.
• The program included intradialytic cycling, walking, and isolated wrist exercises.

Main Methods:

• A randomized controlled trial involving 100 HD patients allocated to an exercise or control group.
• The exercise group underwent a 12-week program of aerobic and resistance exercises.
• Vascular access diameter was the primary outcome, assessed by ultrasound; secondary outcomes included functional capacity, depression, and quality of life.

Main Results:

• The exercise group showed a significant increase in vessel diameter (0.9 ± 0.3 mm) compared to the control group (0.1 ± 0.2 mm; P <.01).
• Significant improvements were noted in 6-minute walk test distance, Beck Depression Inventory scores, and all KDQOL-36 domains (P <.05).
• Age and HD duration were identified as predictors of vascular adaptation.

Conclusions:

• A 12-week structured exercise program effectively improved vascular access diameter and both functional and psychological outcomes in HD patients.
• Tailored exercise interventions can serve as a valuable, noninvasive addition to standard dialysis care.
• Clinical Trial Registration: NCT06428773.