Abstract: FR-PO1045
Acute Brain-Derived Neurotrophic Factor Response to Intradialytic Exercise During Hemodiafiltration: Role of Cognitive Reserve and Exercise Dose
Session Information
- Hemodialysis: Clinical Challenges, Patient-Centered Outcomes, and Quality of Life
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Garza Romero, Maria Fernanda, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Mexico
- Moedano Atristain, José Eduardo, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Mexico
- Flores Pérez, Cinthia Sofia, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Mexico
- Ramirez-Castillo, Normando, Universidad Nacional Autonoma de Mexico Facultad de Estudios Superiores Zaragoza, Mexico City, Mexico
- Lara Díaz, Julieta, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Mexico
- Pérez Molina, Amado, Instituto Nacional de Psiquiatria Ramon de la Fuente Muniz, Mexico City, Mexico
- Cruz, Carlos, Instituto Nacional de Psiquiatria Ramon de la Fuente Muniz, Mexico City, Mexico
- Lopez-Gil, Salvador, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Mexico
Background
Exercise training increases serum BDNF (brain-derived neurotrophic factor) in hemodialysis patients. Whether a single intradialytic session can modify this response, and whether cognitive function and exercise dose determine individual benefit, remains unknown.
Methods
Randomized, within-person crossover trial (n=24) in hemodiafiltration (HDF) patients. Participants completed one exercise session (90-min intradialytic cycling at cardiopulmonary exercise testing-guided intensity) and one control session. Serum BDNF was measured at 0, 90, and 180 min. A Bayesian linear mixed model examined the Montreal Cognitive Assessment (MoCA) and relative peak power output (W/kg) as moderators of the exercise-control difference over time.
Results
Mean age 40.9±13.2 years, 39% male, vintage 76.8±43.7 months, the most common etiology of kidney failure was unknown in 14 patients (58.3%), followed by glomerular disease in 5 (20.8%), and other causes in 4 (16.7%), with diabetic kidney disease in 1 (4.2%). MoCA 23.7±3.3, W/kg 0.46±0.30. BDNF declined during both sessions. Exercise had no overall effect on BDNF at 180 min (22% probability of benefit). The BDNF response at 180 min varied by cognitive reserve and exercise dose. Patients with mild cognitive impairment (MoCA<26) exercising above the group median W/kg (n=10) showed 3.0-fold higher BDNF at 180 min versus their own control session (95% credible interval: 1.03 to 9.4; posterior probability = 97.7%). This effect diminished progressively with increasing MoCA, was absent near MoCA=25, and favored the control session in cognitively intact patients (MoCA≥27).
Conclusion
Single-session intradialytic exercise does not modify BDNF on average. Patients with mild cognitive impairment who exercise at sufficient intensity show substantial neurotrophic preservation, identifying cognitive reserve and exercise dose as key determinants of response and supporting their use to individualize intradialytic exercise prescription.