Abstract
Sedentary lifestyle is frequent in hemodialysis patients whose physical capabilities are largely reduced when compared with healthy subjects, and evidence exists that sedentary dialysis patients are at higher risk of death as compared to non-sedentary ones. Dialysis patients may suffer from cardiovascular disease, diabetes, malnutrition, depression, which limits their exercise capacity; conversely, regular physical exercise may favor rehabilitation and correction of several cardiovascular, metabolic and nutritional abnormalities. Many observational, population-based studies show that the level of physical activity is related to quality of life and nutritional status, as well as to the survival probability. Intervention studies are instead lacking; a randomized controlled multicenter trial is in progress in Italy to assess the effect of home-based exercise programs on survival and hospitalization rate in stable dialysis patients. Implementation of physical activity should be one of the goals of dialysis care management, but several barriers prevent a widespread implementation of physical exercise programs in the dialysis units. A lack of patients’ or care-givers’ motivation or willingness, and structural or functional resources are the most frequent obstacles to exercise implementation. Since the hemodialysis population is quite heterogeneous for physical abilities and comorbidities, exercise in not for everyone and individual prescription is required for a correct and safe implementation of physical activity.
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References
Koufaki P, Kouidi E (2010) Current best evidence recommendations on measurement and interpretation of physical function in patients with chronic kidney disease. Sports Med 40:1055–1074
Robinson-Cohen C, Littman AJ, Duncan GE, Roshanravan B, Ikizler TA, Himmelfarb J, Kestenbaum BR (2012) Assessment of physical activity in chronic kidney disease. J Ren Nutr, June 26
Cupisti A, Capitanini A, Betti G, D’Alessandro C, Barsotti G (2011) Assessment of habitual physical activity and energy expenditure in dialysis patients and relationships to nutritional parameters. Clin Nephrol 75:218–225
Avesani CM, Trolonge S, Deléaval P, Baria F, Mafra D, Faxén-Irving G, Chauveau P, Teta D, Kamimura MA, Cuppari L, Chan M, Heimbürger O, Fouque D (2012) Physical activity and energy expenditure in haemodialysis patients: an international survey. Nephrol Dial Transplant 27:2430–2434
Beddhu S, Baird BC, Zitterkoph J, Neilson J, Greene T (2009) Physical activity and mortality in chronic kidney disease (NHANES III). Clin J Am Soc Nephrol 4:1901–1906
O’Hare AM, Tawney K, Bacchetti P, Johansen KL (2003) Decreased survival among sedentary patients undergoing dialysis: results from the dialysis morbidity and mortality study wave 2. Am J Kidney Dis 41:447–454
Stack AG, Molony DA, Rives T, Tyson J, Murthy BV (2005) Association of physical activity with mortality in the US dialysis population. Am J Kidney Dis 45:690–701
Matsuzawa R, Matsunaga A, Wang G, Kutsuna T, Ishii A, Abe Y, Takagi Y, Yoshida A, Takahira N (2012) Habitual physical activity measured by accelerometer and survival in maintenance hemodialysis patients. Clin J Am Soc Nephrol 7:2010–2016
Johansen KL, Kaysen GA, Dalrymple LS, Grimes BA, Glidden DV, Anand S, Chertow GM (2012) Association of physical activity with survival among ambulatory patients on dialysis: the comprehensive dialysis study. Clin J Am Soc Nephrol, Nov 2
Bulckaen M, Capitanini A, Lange S, Caciula A, Giuntoli F, Cupisti A (2011) Implementation of exercise training programs in a hemodialysis unit: effects on physical performance. J Nephrol 24:790–797
Capitanini A, Cupisti A, Mochi N, Rossini D, Lupi A, Michelotti G, Rossi A (2008) Effects of exercise training on exercise aerobic capacity and quality of life in hemodialysis patients. J Nephrol 21:738–743
Heiwe S, Jacobson SH (2011) Exercise training for adults with chronic kidney disease. Cochrane Database Syst Rev 5(10): CD003236
Delgado C, Johansen KL (2012) Barriers to exercise participation among dialysis patients. Nephrol Dial Transplant 27:1152–1157
Bennett PN, Breugelmans L, Barnard R, Agius M, Chan D, Fraser D, McNeill L, Potter L (2010) Sustaining a hemodialysis exercise program: a review. Semin Dial 23:62–73
Manfredini F, Mallamaci F, Catizone L, Zoccali C (2012) The burden of physical inactivity in chronic kidney disease: is there an exit strategy? Nephrol Dial Transplant 27:2143–2145
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Cupisti, A., D’Alessandro, C., Bottai, A. et al. Physical activity and exercise training: a relevant aspect of the dialysis patient’s care. Intern Emerg Med 8 (Suppl 1), 31–34 (2013). https://doi.org/10.1007/s11739-013-0917-y
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DOI: https://doi.org/10.1007/s11739-013-0917-y