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Kidney Week

Abstract: FR-PO0411

Short-Term Efficacy and Safety of Intradialytic Exercise: Benefit for Highly Comorbid Population?

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Castor Hernández, Rogelio de Jesús, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Sanchez Cardenas, Monica, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Borbolla-Flores, Paola, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Rodríguez Cerda, Tanya Paola, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Carrillo Martínez, Kenia, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Luna Jimenez, Angel Antonio, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Domínguez García, Delmar Yahir, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Medina Cerda, Axel A, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Martínez Barrera, Melissa, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Alvarado Calderón, Miriam Dayana, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
  • Olivo, Mara Cecilia, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, N.L., Mexico
Background

In Mexico, Chronic Kidney Disease (CKD) is the the fifth leading cause of death with an increasing trend. Patients undergoing maintenance hemodialysis typically have low physical activity, worsening their health outcomes. Intradialytic exercise, specifically cycling, has shown documented effects on cardiovascular health and physical function.

Methods

This study recruited adult patients receiving maintenance hemodialysis two or three times weekly at a tertiary care hospital in Monterrey, Mexico. The intervention involved 60 minutes of cycling during each hemodialysis session over 8 weeks. The primary outcome was the change in distance covered in the 6-minute walk test before and after the intervention, assessing efficacy. The frequency of adverse events was measured for safety.

Results

Fifty-nine patients were evaluated; 27 were excluded for not meeting inclusion criteria. Of the 32 who started the intervention, two withdrew consent and one died, leaving 29 for final analysis. The cohort was 50% male and female, with a mean age of 52.6 years (±14.77). Common comorbidities included hypertension (96.3%), diabetes (53.8%), and heart failure (46%). The mean Charlson Comorbidity Index was 4.73 (±1.95). Only 42.3% of patients received hemodialysis three times weekly, with the rest twice weekly; the median time on hemodialysis was 13 months (IQR 8.5 - 31.25). A central venous catheter was the most frequent vascular access (88.5%). Mean hemoglobin was 9.59 g/dL (±2.02), urea nitrogen 88.92 mg/dL (±47.02), serum sodium 135.7 mEq/L (±2.96), and serum potassium 5.5 mEq/L (±1.06). Adherence to planned sessions was 89.06%, with an average of 3607.96 rotations per session. A significant improvement in the 6-minute walk test distance was observed (280.25 vs 366.14 meters, p = 0.029). Adverse events occurred in 12.28% of sessions, most frequently leg pain (8.77%), followed by intradialytic hypotension (2.63%) and hospitalizations (0.8%). No anginal events were reported.

Conclusion

Our study indicates that intradialytic exercise is effective and associated with a low proportion of adverse events, even without an ideal patient population.

Digital Object Identifier (DOI)