Kidney Week

Abstract: FR-PO701

Home-Based Aerobic and Resistance Exercise Training on Peritoneal Dialysis Patients: A Randomized Controlled Trial

Session Information

• Dialysis: Peritoneal Dialysis - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 703 Dialysis: Peritoneal Dialysis

Authors

• Uchiyama, Kiyotaka, Keio University, School of Medicine, Tokyo, Japan

Kiyotaka Uchiyama,

• Wakino, Shu, Keio University, School of Medicine, Tokyo, Japan

Shu Wakino,

• Washida, Naoki, Keio University, School of Medicine, Tokyo, Japan

Naoki Washida,

• Morimoto, Kohkichi, Keio University, School of Medicine, Tokyo, Japan

Kohkichi Morimoto,

• Kasai, Takahiro, International University of Health and Welfare School of Medicine, Chiba, Japan

Takahiro Kasai,

• Itoh, Hiroshi, Keio University, School of Medicine, Tokyo, Japan

Hiroshi Itoh,

Background

Muscle wasting, common and progressive in uremic patients, is associated with a high probability for morbidity, lower health-related quality of life (HRQOL), and mortality. However, potential effect of aerobic and resistance training on peritoneal dialysis (PD) patients has not been fully elucidated. This randomized, controlled study investigated whether a home-based exercise program for PD patients would improve their physical function, PD-related parameters and HRQOL.

Methods

47 PD participants (mean age, 64 years; mean PD vintage, 3.8 years; 35 men) were randomly assigned to home-based training (n = 24) or usual care (n = 23). Participants were included if they started PD more than 3 months prior to baseline assessment. Patients were excluded if they had unstable medical conditions. Home-based-exercise patients were instructed to perform aerobic exercise at 40–60% of the peak oxygen uptake (VO_2peak) thrice weekly, and resistance training at 70% one-repetition maximum twice weekly for 12 weeks. Exercise capacity was assessed by VO_2peak estimated from incremental shuttle walking test and handgrip and quadriceps strength. In addition to evaluation of PD-related parameters, HRQOL was assessed by the Kidney Disease Quality of Life-Short Form questionnaire.

Results

44 participants completed the study (home-based training, n = 22; usual care, n = 22). Analyses of covariance, adjusted for baseline values, revealed significant differences between home-based training and usual care in VO_2peak (12.5 ± 3.6 to 13.1 ± 4.2 mL/kg･min versus 11.9 ± 2.8 to 11.2 ± 3.1 mL/kg･min; P = 0.02) and serum albumin (3.46 ± 0.49 to 3.51 ± 0.44 g/dl versus 3.55 ± 0.41 to 3.42 ± 0.47 g/dl; P = 0.03). Moreover, compared to usual care group, exercise group showed significant improvements in HRQOL scores of physical role functioning (P = 0.02) and role/social component summary (P < 0.01), as well as non-significant improvements in kidney disease component summary (P =0.06), bodily pain (P = 0.07), and vitality (P = 0.06). There were no reported adverse events as a result of the intervention.

Conclusion

A 12-week home-based aerobic and resistance exercise improved aerobic capacity, serum albumin and HRQOL in PD patients. The present study demonstrated for the first time, the efficacy of home-based training in PD patients.