EFFECTS OF INTRA DIALYTIC EXERCISES ON QOL OF PATIENTS ON MHD

Introduction:

End stage renal disease (ESRD)patients require some form of renal replacement therapy (RRT) (Hemodialysis(HD), peritoneal dialysis(PD) to sustain life. The prevalence of ESRD is increasing annually HD is an important and commonly used RRT for ESRD patients.The prevalence of Malnutrition ,Skeletal Muscle Loss, Anemia , Uremia, Chronic inflammation and physical inactivity, together with ‘enforced’ sedentary time during HD contribute to a reduction in exercise and functional capacity that are associated with disability, increased healthcare utilisation and reduced quality of life (QoL) in patients on MHD.The Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend a full integration of exercise in the daily life of chronic kidney disease patients (at least 30 min/day, 5 times a week) taking into consideration their cardiovascular health and level of tolerance .For people receiving dialysis, the most convenient time to perform exercise is during the dialysis treatment.Compared with Off dialysis exercise, intradialytic exercise (IDE) has more advantages including no transportation is required, more free time, a lower participant dropout rate, higher motivation, and a safer, structured environment with close monitoring.

Methods:

Prospective Open Labeled Randomized Control Study, Patients who had been on MHD for >3months were eligible for the study. Exercises were performed at a rating of perceived exertion (RPE) of 10–13 on the Borg scale and RPE 8–10 for warm-up and cool down. Resistance was applied to the wrist and ankle, respectively and aerobic exercise (in- bed pedaling using weight cuffs/sandbags (range 0.5 kg to 4 kg) depending up on patients’ tolerance for 10 min) In each HD session, 4 motor actions were performed. The KDQOL™-36 questionnaire was used for measuring the QOL of patients with ESRD and Pittsburgh sleep scale for QOS.

Results:

A total of 120 participants underwent randomization: 60 in to exercise group (usual care + IDE) and 60 in to control (usual care) group, 10 patients in exercise group and 9 patients in control group did not complete 12 wk. assessment period. The exercise group had mean age of 43.70 yrs. (SD=12.48), while the control group had a mean age of 43.68 yrs. (SD=11.69). Majority of the participants in both the exercise and control group were males (64%). The results of the study demonstrated an improvement in the QOL and QOS of the patients on MHD following the IDE intervention. In terms of biochemical markers and dialysis adequacy , the study found that the exercise program led to improvements in serum potassium levels and hemoglobin levels. However, there were no significant changes observed in solute clearance like calcium, phosphorus, sodium, lipid profile, albumin levels.

Conclusions:

This suggests that incorporating exercise into the Hemodialysis routine can have positive effects on the patients' overall well-being and perceived health. Limitations are single centr study, short duration, effects of nutrient supplementations not included.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.