Abstract: SA-OR063
Timing of Intradialytic Exercise and Its Impact on Intradialytic Hypotension: A Randomized Crossover Study
Session Information
- Hemodialysis Potpourri
November 09, 2019 | Location: 144, Walter E. Washington Convention Center
Abstract Time: 05:30 PM - 05:42 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1300 Health Maintenance, Nutrition, and Metabolism
Authors
- Rossum, Krista Frances, University of Manitoba, Winnipeg, Manitoba, Canada
- Thompson, Stephanie E., University of Alberta, Edmonton, Alberta, Canada
- Hancock, Evelyn K., Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
- Riehl-Tonn, Victoria, University of Calgary, Calgary, Alberta, Canada
- Brar, Ranveer Singh, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
- Leon mantilla, Silvia Juliana, Seven oaks General Hospital. Chronic Disease innovation Center, Winnipeg, Manitoba, Canada
- MacRae, Jennifer M., University of Calgary, Calgary, Alberta, Canada
- Bohm, Clara, University of Manitoba, Winnipeg, Manitoba, Canada
Background
Intradialytic cycling improves physical function and quality of life in hemodialysis and appears safe. Due to concerns regarding increased intradialytic hypotension (IDH), experts recommend that intradialytic cycling be completed during the first half of treatment. However, this recommendation limits the use of intradialytic cycling as a therapeutic tool to improve intradialytic symptoms, which are more common in the latter half of treatment.
We compared the rate of IDH while cycling during the first half of hemodialysis (early) versus the second half (late).
Methods
We performed a multi-centre randomized crossover study in adults (> 18 years old) on chronic (>3 months), in-centre hemodialysis who were participating in a clinical intradialytic cycling program at three Canadian academic centres between July 1, 2018 and Mar 31, 2019. Group A cycled in the first half of hemodialysis for 2 weeks and then in the second half for the subsequent 2 weeks. In Group B, the exercise schedule was reversed. Blood pressure was measured every 15 minutes throughout hemodialysis. We compared rate of IDH (episodes IDH/100 hemodialysis hours) with early and late intradialytic exercise. IDH was defined as a >20 mmHg drop from baseline BP OR a drop in systolic BP to <90 mmHg during hemodialysis. Data was analyzed using a general linear mixed model with random intercept and negative binomial regression.
Results
Eighty-four participants were included in the analysis. Group A (n=43, 32.6% female, 64.5 ±11.9 years) had a mean time on hemodialysis of 3.93 (0.26) hours and exercised for an average of 54.7 minutes. Group B (n=41, 41.5% female, 52.6 ± 13.5 years) had a mean time on hemodialysis of 3.90 (0.23) hours and exercised for an average of 50.2 minutes. The rate of IDH per 100 hemodialysis hours was 35.7 and 37.6 when cycling during the first half and second half of hemodialysis, respectively; p=0.11.
Conclusion
There was no association between IDH and the timing of intradialytic cycling. Exercise late in hemodialysis will facilitate expansion of intradialytic cycling programs by optimizing resource use and will enable the use of cycling as a potential non-pharmacological means of improving hemodialysis-related symptoms.