Korean J Intern Med.  2019 May;34(3):588-598. 10.3904/kjim.2017.020.

Intradialytic exercise improves physical function and reduces intradialytic hypotension and depression in hemodialysis patients

• Rhee SY
• Song JK
• Hong SC
• Choi JW
• Jeon HJ
• Shin DH
• Ji EH
• Choi EH
• Lee J
• Kim A
• Choi SW
• Oh J

• KMID: 2448351
• DOI: http://doi.org/10.3904/kjim.2017.020

Abstract

BACKGROUND/AIMS
As numbers of maintenance hemodialysis patients are growing, debilitating conditions of muscle wasting and atrophy are becoming some of the greatest concerns in end-stage renal disease patients. Exercise training has various potential benefits in terms of prevention of a sustained decline in functional status. This study aimed to evaluate the physical, psychological, laboratory, and dialysis-related effects of intradialytic exercise.
METHODS
We enrolled 22 patients from a hemodialysis center for a 6-month non-randomized prospective trial. Combination of aerobic exercise with bicycle ergometer and anaerobic exercise with elastic bands was conducted during hemodialysis. Data including physical fitness test results, dialysis-related measurements, and biochemical laboratory results were collected at baseline, 3, and 6 months. Depression and quality of life were assessed using Beck Depression Inventory and Short Form-36 health survey.
RESULTS
After exercise completion, there were significant improvements in back muscle power, forward and backward trunk flexibility, vertical jump, elbow flexion, sit to stand test, and 6-minute walk test (p < 0.05). No significant changes were observed in dry weight, blood pressure, Kt/V, and biochemical variables, except for intradialytic hypotension (p < 0.05). For depression, Beck Depression Inventory showed statistically significant enhancement (p < 0.05). Scores of Short Form-36 health survey did not show significant increase in each domain, except for bodily pain (p < 0.05).
CONCLUSIONS
Combined aerobic and anaerobic exercise training during dialysis was found to be effective on physical health status, intradialytic hypotension, and depression in terms of mental health. Therefore, the findings of the current study may provide an appropriate guidance for encouraging exercise by nephrologists.

Keyword

Renal dialysis; Intradialytic exercise; Physical function; Intradialytic hypotension; Depression

MeSH Terms

Atrophy
Back Muscles
Blood Pressure
Depression*
Dialysis
Elbow
Exercise
Health Surveys
Humans
Hypotension*
Kidney Failure, Chronic
Mental Health
Physical Fitness
Pliability
Prospective Studies
Quality of Life
Renal Dialysis*