Kidney Week

Abstract: TH-PO305

Long-Term Follow-Up of Respiratory Function in Maintenance Hemodialysis Patients Following an In - Center Exercise Program for 24 Months

Session Information

• Dialysis: Cost, Socioeconomics, Quality of Life
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Bozikas, Andreas, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Andreas Bozikas,

• Papacharalambous, Maroula, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Maroula Papacharalambous,

• Pisanidou, Pinelopi, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Pinelopi Pisanidou,

• Vakiani, Styliani, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Styliani Vakiani,

• Martika, Antigoni, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Antigoni Martika,

• Kiriakoutzik, Iliana, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Iliana Kiriakoutzik,

• Kitoukidi, Eleni, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Eleni Kitoukidi,

• Akrivopoulos, Ioannis, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Ioannis Akrivopoulos,

• Falakidou, Soultana, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Soultana Falakidou,

• Papastergiou, Stergios, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Stergios Papastergiou,

• Spaia, Sofia, General Hospital of Thessaloniki "Agios Pavlos", Thessaloniki, Greece

Sofia Spaia,

Background

In spite the well documented benefit of physical exercise on hemodialysis patients (HD) only few reports concern the long-term effect on respiratory function.
We designed this study to investigate the effects of continuous moderate-intensity programme applied during hemodialysis sessions by a physiotherapist, on parameters in spirometry.

Methods

We enrolled 60 maintenance HD patients in this study. 44 stable HD patients participated in a 20 – 30 minute exercise program of moderate intensity targeting muscle strengthening and elasticity, articular flexibility in every session for 24 months. 16 HD patients who did not participated served as controls.
Spirometry: Forced Vital Capacity (FVC), FVC %, Forced Expiratory Volume in One second (FEV1), FEV1 % and Forced Expiratory Flow over middle half of the FVC – that is, average flow from 25 % of the FVC to 75 % of the FVC during forced expiration (FEF 25 – 75 %) was performed at 0, 12 and 24 months along with biochemical tests: Hct, CRP, Chol, TG, LDL, HDL, TP, Alb, HbA1C and dialysis adequacy (Urr, Kt/V).

Results

Overwhelming acceptance of the program resulted in continuous and constant participation. 7 patients (12 %) were found with undiagnosed COPD in the beginning of the study.
Respiratory indices were comparable either the test was performed before or after the HD session.
FEV1/FVC index was improved at 12 months and remained improved at 24 months only in the exercising group (76.6 ± 10 v s79.6 ± 8 vs 81.5 ± 7, p<0.05).

Conclusion

Adaptation of a thrice weekly exercise program under physiotherapist guidance resulted in the enthusiastic participation of patients and it is one of the longest that have been reported. Patients following the long term exercise improved FEV1/FVC over the follow-up period.
Evaluation of respiratory function should be performed in all patients starting dialysis since it reveals latent morbidity.
In spite the reports of deterioration of pulmonary function in the long term of maintenance HD the latter remained stable in the control group.