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Effect of blood volume change related to intensity of intradialytic aerobic exercise on hemodialysis adequacy: a pilot study

  • Nephrology - Original Paper
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Abstract

Purpose

Intradialytic exercise may improve dialysis efficiency; however, the association between changes in blood volume (BV) related to exercise intensity and solute removal kinetics remains unknown. We herein investigated the relationship between changes in BV with exercise and removal of solute molecules during hemodialysis.

Methods

Each of the 21 hemodialysis patients underwent cardiopulmonary exercise test to measure anaerobic threshold (AT). According to the exercise intensity, patients were classified into two groups, the low group (n = 12), whose intensity was below the AT, and the high group (n = 9), whose intensity was at the AT level. Each patient completed two trial arms of resting and discontinuous exercise dialysis sessions in a randomized manner.

Results

The change in BV with the exercise dialysis session in the high group decreased during exercise (p = 0.028) and remained decreased after exercise (p = 0.016), compared with the low group. In the low group, compared with routine sessions, the removal of potassium (p = 0.030), phosphate (p = 0.024), and urea nitrogen (p = 0.065) increased during exercise, but the total removal of these solutes did not change. In the high group, the removal of phosphate (p < 0.001) and urea nitrogen (p = 0.018) after exercise and even total phosphate (p = 0.027) decreased.

Conclusion

These findings suggest that the removal of small solute molecules is improved during exercise in intradialytic low-intensity exercise with no change in BV, and decreased after exercise in high-intensity exercise with a decrease in BV.

Clinical Trials Registry

Trial retrospectively registered at the UMIN Clinical Trials Registry: study number UMIN000038629 (Registration date: September 7, 2019).

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Data availability

The data underlying this article are available in the University hospital Medical Information Network Individual Case Data Repository, [https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043840], on reasonable request to the corresponding author.

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Funding

This study was funded by Kisen Hospital.

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Kisen Hospital, 1-35-8 Higashikanamachi, Katsushika-ku, Tokyo, 125-0041, Japan

    Naoto Usui & Sho Kojima

  2. Department of Nephrology, Graduate School of Medicine, Juntendo University, Tokyo, Japan

    Naoto Usui, Junichiro Nakata & Yusuke Suzuki

  3. Division of Cardiology, Kisen Hospital, Tokyo, Japan

    Akimi Uehata

  4. Division of Nephrology, Kisen Hospital, Tokyo, Japan

    Akihito Inatsu

  5. Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan

    Atsuhiro Tsubaki & Sho Kojima

  6. Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan

    Masakazu Saitoh

  7. Division of Nephrology, Komae Renal Clinic, Tokyo, Japan

    Tomoko Izumi

  8. Department of Clinical Engineering, Kisen Hospital, Tokyo, Japan

    Yasuo Chiba

Authors
  1. Naoto Usui
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  2. Akimi Uehata
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  10. Yusuke Suzuki
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Contributions

NU, AU, AI, and TI contributed study conception and design. NU, AU, SK, and YC collected the data. NU, JN, AT, MS, and YS contributed to analysis and interpretation of the data. AU and NU drafted the manuscript. All the authors critically reviewed the manuscript and approved the final version.

Corresponding author

Correspondence to Naoto Usui.

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Conflict of interest

No conflicts of interest, financial or otherwise, are declared by the authors.

Ethics approval

This study complied with the Helsinki Declaration and was approved by the Ethics Review Board at Kisen Hospital (No. 28–01).

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All the patients provided written informed consent.

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Usui, N., Uehata, A., Nakata, J. et al. Effect of blood volume change related to intensity of intradialytic aerobic exercise on hemodialysis adequacy: a pilot study. Int Urol Nephrol 54, 1427–1434 (2022). https://doi.org/10.1007/s11255-021-03038-8

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  • DOI: https://doi.org/10.1007/s11255-021-03038-8

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