Effect of Intradialytic Exercise on Left Ventricular Diastolic Function in Hemodialysis Patients

Summary

Introduction: Cardiovascular disease is the leading cause of morbidity and mortality in patients undergoing hemodialysis, largely due to structural cardiac changes associated with left ventricular diastolic dysfunction. In addition, this population has a high prevalence of sedentary behavior, which has been associated with increased mortality. Recent studies in patients with chronic kidney disease have shown that structured exercise interventions improve several parameters related to cardiovascular health.

Objectives: To evaluate the effect of implementing systematic intradialytic exercise on left ventricular diastolic function.

Materials and Methods: This will be a quasi-experimental before-and-after study conducted in two phases. During the first phase (control), prevalent hemodialysis patients will receive standard treatment for 16 weeks. Transthoracic echocardiography will be performed at baseline and repeated at the end of this phase to assess left ventricular diastolic function parameters. During the second phase (intradialytic exercise), participants will undergo a 16-week supervised and prescribed intradialytic aerobic exercise program consisting of intradialytic cycling. Exercise intensity will be individualized according to cardiopulmonary exercise testing (CPET), which will be performed at the beginning and end of this phase. A final echocardiogram will be obtained at the end of the intervention phase. In addition, a 6-minute walk test and a validated physical activity questionnaire will be administered monthly throughout both phases of the study.

Conditions

• Renal Dialysis
• Hemodiafiltration
• Diastolic Dysfunction
• Kidney Failure
• Quality of Life
• Aerobic Training

Interventions

OTHER

Not exercise

Patients were instructed to discontinue any unstructured exercise previously performed during their hemodiafiltration sessions for 16 weeks. Hemodiafiltration sessions continued unchanged according to the center's standard of care.

OTHER

Exercise during hemodiafiltration session

A 16 weeks of Intradialytic exercise program that is performed using cycle ergometers during the hemodiafiltration session. Exercise intensity is quantified in watts using power meters and is individualized according to each participant's performance on cardiopulmonary exercise testing (CPET).

Sponsors & Collaborators

• Instituto Mexicano de Investigaciones Nefrológicas

  collaborator UNKNOWN

• Instituto Nacional de Cardiologia Ignacio Chavez

  lead OTHER

Study Design

Allocation

NA

Purpose

TREATMENT

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-09-17

Primary Completion

2024-09-30

Completion

2024-10-30

Countries

• Mexico

Study Locations