Effects of intradialytic cycling exercise on daily physical activity, physical fitness, body composition, and clinical p
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NEPHROLOGY - ORIGINAL PAPER
Effects of intradialytic cycling exercise on daily physical activity, physical fitness, body composition, and clinical parameters in high‑volume online hemodiafiltration patients: a pilot randomized‑controlled trial Nawaporn Assawasaksakul1 · Worawan Sirichana2 · Waraporn Joosri1,3 · Onanong Kulaputana4 · Sukanya Eksakulkla5 · Chutima Ketanun1,3 · Piyawan Kittiskulnam1 · Maythinee Chantadisai6 · Kullaya Takkavatakarn1 · Paweena Susantitaphong1 · Kearkiat Praditpornsilpa1 · Somchai Eiam‑Ong1 · Khajohn Tiranathanagul1 Received: 10 June 2020 / Accepted: 3 October 2020 © Springer Nature B.V. 2020
Abstract Purpose The mortality of dialysis patients treated with high-volume online hemodiafiltration (OL-HDF) is better than hemodialysis, but is still higher than healthy population. Low daily physical activity increases cardiovascular mortality. Addition of intradialytic exercise (IDX) program might improve physical activity and health status in OL-HDF patients. This pilot open-labeled randomized-controlled trial was conducted to evaluate the effects of IDX on physical activity and other clinical parameters in OL-HDF patients. Methods Twelve OL-HDF patients were randomized into control (n = 6) or IDX (n = 6) groups. The subjects in IDX group were trained to exercise using a cycle ergometer for 60 min during each OL-HDF session. Physical activity measured as daily step count using a wrist-worn triaxial accelerometer, physical fitness, or cardiorespiratory fitness assessed by VO2max and other physical performance tests, lean body mass determined by the Dual-energy X-ray absorptiometry (DXA), quality of life (QOL), and various parameters were compared between baseline and 6 months. Results The baseline physical activity status was comparable. Following 6-month IDX, the physical activity was significantly improved in IDX group [+ 1048.79 (+ 741.50, + 2792.54) vs. − 362.06 (− 1626.82, − 167.47) steps/day, p = 0.01], while physical fitness and QOL were unchanged. The lean body mass parameters were preserved in the IDX group while seemed to decrease in the control group. Serum albumin was significantly increased in the IDX group (p = 0.01). The hemoglobin changes were significantly better (p = 0.01) and the erythropoietin resistance index was significantly lower in the IDX group (p = 0.03). Phosphate reduction was significantly greater in the IDX group (p = 0.04). Conclusions IDX could improve physical activity and other metabolic parameters in OL-HDF patients and these might contribute to further improvement in clinical and survival outcomes. Trial registration ClinicalTrials.gov Registration: NCT03353844. Keywords Intradialytic exercise · Physical activity · Triaxial accelerometer · Online hemodiafiltration
Introduction
A portion of this study was presented as “poster presentation” at the American Society of Nephrology (ASN) Kidney Week 2018, San Diego, CA, USA. * Khajohn Tiranathanagul [email protected] Extended author information available on the last page of the article
High-volume
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