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Exercise tolerance in patients on chronic hemodialysis
Israel Journal of Medical Sciences
|January 1, 1980
Summary
Patients undergoing chronic hemodialysis exhibit reduced physical work capacity due to early muscular fatigue. This limitation is linked to rapid anaerobic metabolism, potentially stemming from insufficient maximal oxygen uptake.
Area of Science:
- Nephrology
- Exercise Physiology
- Metabolic Studies
Background:
- Chronic hemodialysis patients often experience reduced physical function.
- Understanding the limitations in physical work capacity is crucial for improving patient quality of life.
Purpose of the Study:
- To determine the near-maximal physical work capacity of patients on chronic hemodialysis.
- To identify the physiological factors contributing to exercise limitations in this population.
Main Methods:
- Twenty-two chronic hemodialysis patients performed exercise tests on a bicycle ergometer.
- Physical work capacity was assessed by measuring oxygen consumption, oxygen pulse, blood lactic acid, and double product (systolic blood pressure x heart rate).
- Exercise cessation was determined by subjective muscular fatigue.
Main Results:
- Patients demonstrated significantly lower physical work capacity compared to healthy controls.
- Exercise termination was associated with high blood lactic acid levels and increased double product, indicating high cardiac output.
- Oxygen consumption and oxygen pulse were comparable to controls at similar workloads.
Conclusions:
- Limited physical work capacity in hemodialysis patients is primarily attributed to early muscular fatigue.
- This fatigue may result from the rapid onset of anaerobic metabolism.
- A potential underlying cause is limited maximal oxygen uptake.