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A single bout of hybrid intradialytic exercise did not affect left-ventricular function in exercise-naïve dialysis patients: a randomized, cross-over trial

  • Nephrology - Original Paper
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Abstract

Introduction

Cardiovascular diseases are the leading cause of mortality in end-stage renal disease (ESRD) patients, especially those receiving hemodialysis (HD) therapy. HD has many side effects that are related to patients’ hearts, such as recurrent myocardial ischemia and global or segmental left-ventricular dysfunction, which is associated with intradialytic hypotension, long-term loss of systolic function, and high incidence of cardiovascular events and death. Systematic exercise training has a beneficial effect on measures of cardiovascular fitness and reducing cardiovascular risk factors in ESRD. Whether there is an acute benefit of exercise during HD on left-ventricular function is not well known. The current study aimed to investigate whether a single bout of hybrid (aerobic and resistance) intradialytic exercise could affect left-ventricular function during HD sessions.

Methods

Twenty-one exercise naïve and clinically stable HD patients participated in the study. All participants completed two different HD trials on two different days, separated by 1 week: (1) standard HD and (2) HD including a single bout of hybrid intradialytic exercise. Hybrid intradialytic training included the usual intradialytic cycling followed by resistance training using elastic bands and dumbbells. Echocardiographic assessment of left-ventricular function was completed before HD, half an hour before the end of HD, and 30 min after the end of HD.

Results

Cohort data for left-ventricular function indices were not different between trials and did not change across time in either the standard HD or HD plus exercise trial. Cohort data for the change in ejection fraction from baseline to during HD did mask considerable inter-individual variability (HD − 0 ± 15; HD plus exercise (− 2 ± 20). Despite this, the variability was not mediated by the addition of intradialytic hybrid exercise.

Conclusion

A single bout of hybrid intradialytic exercise did not affect left-ventricular function during the HD therapy. It is important to determine whether chronic exercise training could beneficially affect left-ventricular function abnormalities often observed during the HD therapy.

Trial registration number

The study is registered at ClinicalTrials.gov (NCT01721551) as a clinical trial.

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Availability of data and material

All data and materials of this study are available upon request.

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Acknowledgements

We would like to thank the patients who participated in the present study as well as the nursing staff of the hemodialysis unit of the University hospital of Larissa, Greece for their help and support during the whole process. In addition, we would like to thank Professor Clara Bohm from the University of Manitoba in Canada for her expert review and suggestions.

Funding

This work was supported by the European Union Horizon 2020 Research and Innovation Programme “H2020 MSCAS-RISE-Muscle Stress Relief” under grant agreement no. 645648.

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Authors and Affiliations

  1. School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42100, Trikala, Greece

    Stefania S. Grigoriou, Christina Karatzaferi & Giorgos K. Sakkas

  2. Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus

    Christoforos D. Giannaki

  3. Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK

    Keith George

  4. Department of Medicine, School of Health Science, University of Thessaly, Larissa, Greece

    Paris Zigoulis, Theodoros Eleftheriadis & Ioannis Stefanidis

  5. School of Sports and Health Sciences, Cardiff Metropolitan University, Cardiff, UK

    Giorgos K. Sakkas

Authors
  1. Stefania S. Grigoriou
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  2. Christoforos D. Giannaki
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  3. Keith George
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  4. Christina Karatzaferi
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  5. Paris Zigoulis
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  6. Theodoros Eleftheriadis
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  7. Ioannis Stefanidis
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  8. Giorgos K. Sakkas
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Contributions

SSG, performed the literature review, data acquisition and analysis, draft and revise the first version. CDG, overviewed the data analysis, performed clinical examination of the participants and draft and revised the various version; CK, performed statistical analysis, updated the literature review, draft and revised the various version; KG, performed ecordiography analysis and consultation, contribute to statistical and power analysis, and draft and revised the various version; PZ, recruit patients, performed medical examination, participated in the study design and data analysis and revised the various versions of the paper; TE participated in patients recruitment, data acquisition and analysis, draft and revised the various version; IS participated in the study design, assist in literature review and statistical kai power analysis and draft and revised the various version; GKS conceive the project idea, participated in the study design, overview the whole process of the experiments and analysis and draft all versions of the paper. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors.

Corresponding author

Correspondence to Giorgos K. Sakkas.

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Conflicts of interest/Competing interests

The authors declare no conflicts of interest.

Ethics approval

The study was approved by the Human Research and Ethics Committee of the University of Thessaly (634, 10/10/2012) and performed under ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Consent to participate

All patients gave their written informed consent prior to study participation.

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Yes.

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Grigoriou, S.S., Giannaki, C.D., George, K. et al. A single bout of hybrid intradialytic exercise did not affect left-ventricular function in exercise-naïve dialysis patients: a randomized, cross-over trial. Int Urol Nephrol 54, 201–208 (2022). https://doi.org/10.1007/s11255-021-02910-x

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  • DOI: https://doi.org/10.1007/s11255-021-02910-x

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