Exercise in patients on chronic hemodialysis: current evidence, knowledge gaps and future perspectives

Purpose of review Physical inactivity is common in hemodialysis patients, and is associated with disability and poor outcomes. We summarize the effects of aerobic, resistance or mixed exercise training on aerobic capacity, muscle mass and strength, dialysis efficiency, quality of life and cardiovascular adaptation according to clinical studies on this population, also focusing on knowledge gaps as topics for future research. Finally, we put evidence into clinical context deriving practical indications for exercise implementation in these patients. Recent findings In hemodialysis patients, aerobic or mixed exercise training increases predominantly aerobic capacity, whereas resistance training seems more effective in increasing muscle strength. Data concerning dialysis efficiency are equivocal, although phosphate and potassium clearances seem to be improved. There is also inconclusive evidence concerning changes in cardiovascular risk factors. All types of exercise improve patients’ quality of life. However, there is a need for protocol standardization and selection of easily measurable endpoints. In clinical practice, it is advised that exercise implementation be performed gradually, and goals be tailored to individual pretraining fitness levels to maximize patient adherence and clinical benefits. Summary The overall evidence suggests that exercise training is beneficial and well tolerated in hemodialysis patients, although heterogeneity across studies hinders ge...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - Category: Nutrition Tags: TRANSLATIONAL RESEARCH IN WASTING DISEASES: Edited by Claude Pichard and Mariƫlle P.K.J. Engelen Source Type: research

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Authors: Albalate M, Arribas P, Torres E, Cintra M, Alcázar R, Puerta M, Ortega M, Procaccini F, Martin J, Jiménez E, Fernandez I, de Sequera P, Grupo de Enfermería HUIL, Grupo enfermería HUIL Abstract Dialysis patients are a risk group for SARS-CoV-2 infection and possibly further complications, but we have little information. The aim of this paper is to describe the experience of the first month of the SARS-CoV-2 pandemic in a hospital haemodialysis (HD) unit serving the district of Madrid with the second highest incidence of COVID-19 (almost 1,000 patients in 100,000h). In the form of...
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
Conclusions: Our findings indicate that exercise during dialysis not just suppresses adverse effects in muscle strength and functioning, but effectively and safely increases lower extremities muscle function in a relatively short time.Implications for RehabilitationRegular, progressive, resistance training realized during dialysis is well tolerated and safe for exercise interventions in hemodialysis patients.A 12-weeks intradialytic resistance training is effective in the prevention and clinical management of muscle function loss among hemodialysis patients.The range of improvements in muscle functions, demonstrated by the...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
We describe a representative case, demonstrating the effectiveness of closed-loop stimulation in a patient with hypotension during dialysis. PMID: 32418964 [PubMed - as supplied by publisher]
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
CONCLUSIONS: Physical activity levels, sedentary behavior levels, and muscle strength are related to physical function status for patients receiving dialysis. There is a need for robust longitudinal data to confirm the results of this investigation and for more focus on populations receiving peritoneal dialysis. PMID: 32045878 [PubMed - as supplied by publisher]
Source: Journal of Physical Activity and Health - Category: Sports Medicine Tags: J Phys Act Health Source Type: research
CONCLUSIONS: Important differences separate patients who electively withdraw from those who die of non-withdrawal causes. Worsening disability, in particular, may be a marker for withdrawal. PMID: 32018244 [PubMed - as supplied by publisher]
Source: American Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: Am J Nephrol Source Type: research
PMID: 31917932 [PubMed - as supplied by publisher]
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Publication date: Available online 6 January 2020Source: Journal of Clinical NeuroscienceAuthor(s): Koji Tamai, Akito Yabu, Kazushi Takayama, Teruo Kita, Hideki Sakanaka, Akinobu Suzuki, Hiroaki NakamuraAbstractAs the number of patients with end-stage renal disease (ESRD) has been increasing, the number of cervical spine surgeries for the patients with ESRD has also been increasing. The purpose is to identify the differences in cervical disease-specific patient-reported outcomes (PROs) between a healthy population and patients with ESRD, adjusting for subjects’ age and physical activity.MethodsThe ESRD group included...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Conclusions: Participants indicated a need for co-development with healthcare professionals of differentiated, targeted exercise interventions. Implications for rehabilitation Healthcare professionals should encourage and motivate haemodialysis patients to participate in physical activity (PA). As part of this approach, there is a need to increase patient knowledge of safe beneficial exercise activities and help individuals identify and overcome barriers. To allow for individualised approaches, clinical interventions should focus on other community activities that patients can do outside the dialysis clinic setting and uti...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
Authors: Arenas Jiménez MD, Navarro García M, Serrano Reina E, Álvarez-Ude F Abstract INTRODUCTION: Instrumental Activities of Daily Life (IADL) requires a higher level of personal autonomy and interaction with the environment than the basic activities of daily life (BADL). Few studies analyze the deficit on IADL. Early detection is important because an early action can delay the evolution of the dependency process. AIM: to know the prevalence of functional deficit in IADL of hemodialysis patients, its relationship with the functional deficit in the BADL and its influence on the health rela...
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
This study investigated the relationship among sexual dysfunction, loneliness, social isolation, and self-esteem. In this cross-sectional correlational study, 132 patients undergoing hemodialysis with inclusion criteria were selected through census sampling from hemodialysis centers in Kerman, Iran. Demographic questionnaire, Rosenberg self-esteem scale, young schema questionnaire-short form, revised UCLA loneliness scale, the female sexual function index, and the international index of erectile function were used to collect data, which were analyzed with SPSS18 using descriptive and analytical tests. The mean total score ...
Source: Sexuality and Disability - Category: Disability Source Type: research
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