Abstract: TH-PO1280
Effect of Intradialytic Exercise on Serum Fibroblast Growth Factor 23 (FGF-23) Levels and Left Ventricular Structure and Function in Patients on Hemodialysis: A Randomized Controlled Trial Pilot Study
Session Information
- Late-Breaking Research Posters
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Naka, Seuppong, Bhumibol Adulyadej Hospital, Bangkok, Thailand
- Yoowannakul, Suree, Bhumibol Adulyadej Hospital, Bangkok, Thailand
Group or Team Name
- Bhumibol Adulyadej Hospital
Background
Cardiovascular disease accounts for approximately 50% of mortality in patients undergoing hemodialysis . Elevated Fibroblast Growth Factor 23 has been associated with uremic cardiomyopathy and increased all-cause mortality. Although intradialytic exercise provides several physiological benefits, its effect on serum FGF23 levels remains unclear. This pilot study aimed to evaluate whether intradialytic exercise reduces serum FGF23 and improves left ventricular structure and function.
Methods
A single-center, open-label, randomized controlled trial was conducted in stable chronic HD patients. Participants were randomly assigned in a 1:1 ratio to either a 24-week intradialytic exercise program (aerobic and resistance training) or a usual-care control group. The primary outcome was the change in serum FGF23 levels from baseline to 6 months. Secondary outcomes included echocardiographic parameters LVEF and left ventricular mass, markers of mineral metabolism, inflammatory marker, physical performance, and quality of life assessed by the KDQOL instrument.
Results
Among 60 eligible participants, 49 completed the study (23 in the exercise group and 26 in the control group). After 6 months, there was no significant difference in the change in FGF23 levels between the exercise and control groups ( mean difference 314.98; 95% CI -796.86 to, 142.82; p = 0.57), with substantial inter-individual variability observed. Echocardiographic outcomes showed no significant changes in LVEF (mean difference -1.93; 95% CI -9.23 to 5.37; p = 0.59) or LV mass (mean difference -35.58; 95% CI -87.80 to 16.65; p = 0.17). Regarding mineral metabolism, the exercise group demonstrated a significant reduction in serum calcium (mean difference -0.53; 95% CI -0.98 to -0.08; p = 0.02).A trend toward improvement in mental quality of life scores was observed in the exercise group.
Conclusion
A 6-month intradialytic exercise program did not significantly reduce serum FGF23 levels or improve cardiac structural and function in HD patients. These findings suggest that the systemic uremic mineral burden may not be substantially modified by exercise alone. However, intradialytic exercise remains valuable adjunctive therapy, demonstrating potential benefits in mental well-being and modulation of mineral metabolism.
Funding
- Private Foundation Support