Objective: To describe a systematic review and meta-analysis to identify if intradialytic exercise improves the removal of solutes and the hemodialysis adequacy.
Data Sources: A systematic review and meta-analysis of randomized controlled trials (RCTs) were performed. The sources were MEDLINE (via PubMed), Web of Science, LILACS, and SciELO, from inception until July 2018.
Study Selection: Clinical trials including patients on chronic hemodialysis submitted to the intervention of aerobic intradialytic exercise.
Data Extraction: Evaluating as outcomes the removal of solutes (creatinine, phosphate, potassium) and/or adequacy parameters (Kt/V-urea).
Data Synthesis: The systematic review included 23 studies (7 evaluating the effect of 1 exercise session and 16 evaluating the effect of training, lasting from 6 to 25 weeks). Eleven RCT were included in the meta-analyses. It was observed that the aerobic intradialytic exercise increased the Kt/V-urea (0.15; 95% confidence interval [95% CI], 0.08-0.21) and decreased creatinine (-1.82 mg/dL; 95% CI, -2.50 to -1.13), despite the high heterogeneity of the analysis. No differences were found in phosphorus and potassium removal.
Conclusion: The aerobic intradialytic exercise may be suggested to improve the Kt/V-urea and the creatinine removal during the dialysis.
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http://dx.doi.org/10.1016/j.apmr.2019.02.009 | DOI Listing |
BMC Nephrol
January 2025
Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Żołnierska 54, Szczecin, 71-210, Poland.
Background: The problem of reduced physical activity in patients with stage 5 Chronic Kidney Disease (CKD) is becoming more and more interesting in the medical community. One of the innovative solutions that can significantly increase patients' motivation to exercise is the integration of physical training with virtual reality (VR) technology during hemodialysis. The aim of this study was to comprehensively assess the impact of regular physical activity using virtual reality on the concentration of plasma PCSK9 protein and TNF-α in patients with stage 5 CKD treated with hemodialysis.
View Article and Find Full Text PDFVopr Kurortol Fizioter Lech Fiz Kult
December 2024
Federal Scientific and Clinical Center of Medical Rehabilitation and Balneology of the Federal Medical and Biological agency of Russia, Moscow, Russia.
Unlabelled: Chronic kidney disease (CKD) is a global health problem, CKD is widespread in the world, on average it is detected in 10-13% of the adult population. Sedentary patients with CKD on dialysis have a higher risk of mortality. Despite the significant association of physical function with mortality in patients with CKD, physical function is not routinely assessed and exercise is not a component of the routine management of patients with CKD on dialysis.
View Article and Find Full Text PDFAntioxidants (Basel)
October 2024
Research Laboratory Molecular Bases of Human Pathology LR19ES13, Faculty of Medicine, University of Sfax, Sfax 3029, Tunisia.
Background: This study aimed to investigate the effects of intradialytic concurrent (resistance-endurance) training combined with melatonin (MEL) supplementation on oxidative stress, inflammation, and cellular damage in hemodialysis (HD) patients.
Methods: Thirty-two HD patients were randomly assigned to three groups: Exercise (EX)-MEL, EX-Placebo (PLA), and Control (C)-PLA. Participants in the EX-MEL and EX-PLA groups underwent 12 weeks of concurrent training.
J Bodyw Mov Ther
October 2024
Graduate Program in Biological Sciences - Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil; Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil; Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil.
Purpose: To evaluate the effects of an intradialytic aerobic exercise training program on the expression of transcription factors nuclear factor κappa B (NF-κB) and nuclear factor erythroid 2-related factor 2 (Nrf2), related to inflammatory and antioxidant pathways, respectively, in patients with chronic kidney disease (CKD) on hemodialysis.
Methods: This was a longitudinal, randomized clinical trial with a washout period and crossover performed with 33 patients randomized into two groups: Exercise (individualized intradialytic aerobic exercise on an adapted stationary exercise bike) three times per week for three months and control (without exercise). After the washout period (1 month), the exercise group became the control, and the other group performed the exercises for another three months.
Cureus
October 2024
Surgery, King Edward Medical University, Lahore, PAK.
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