Abstract
AbstractIntroductionPatients with kidney failure experience derangements of circulating markers of mineral metabolism and dysregulation of skeletal and cardiovascular physiology which results in high mortality rate in these patients. This study aimed to evaluate the effect of intradialytic concurrent exercise on regulation of theses abnormalities related parameters in patients receiving hemodialysis (HD).MethodsIn this randomized controlled trial conducted in a HD center in Iran, adult patients receiving chronic HD were randomized to intradialytic exercise (60 minutes) in the second hour of thrice weekly dialysis for 6 months (intervention) or no intradialytic exercise (control). The primary outcomes were serum calcium, serum phosphorous and parathyroid hormone levels. Secondary outcomes were serum alkaline phosphatase and calcium-phosphorous productResultsThe study included 44 participants randomized to intervention (n=22) or control (n=22). During the 6-month intervention period, significant between-group changes were observed in all primary and secondary outcomes between the intervention and control groups. The analysis showed a significant decrease in serum levels of phosphorous and parathyroid hormone (P < 0.05). Statistical analyses reveal a significant increase in serum calcium (P < 0.05) as well as a significant decrease in serum phosphorous, parathyroid hormone, alkaline phosphatase and calcium-phosphorous product (P < 0.05).ConclusionIntradialytic exercise performed for at least 60 minutes during thrice weekly dialysis sessions improves bone mineral metabolism in adult patients receiving HD. Further studies should focus on observing the effect of different types of exercise on bone mineral disorders and all-cause mortality in HD patients.Trial registrationClinicalTrials.govIdentifier:NCT04916743, Registered on June 8th,2021. Registered trial name: The Effect of Intradialytic Exercise on Calcium, Phosphorous and Parathyroid Hormone: A Randomized Controlled Trial
Publisher
Cold Spring Harbor Laboratory
Reference56 articles.
1. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure
2. United States Renal Data System. Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2018. Available at https://www.usrds.org/2018/view/Default.aspx.
3. Exercise training in dialysis patients: impact on cardiovascular and skeletal muscle health
4. SONG Initiative. The SONG Handbook. Version 1.0 June 2017, Sydney,Australia Available at songinitiative.org/reports-and-publications/.
5. An international Delphi survey helped develop consensus-based core outcome domains for trials in peritoneal dialysis