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Intradialytic exercise with blood flow restriction: Something to add to hemodialysis adequacy? Findings from a crossover study
Author(s) -
Dias Etiene C.,
Orcy Rafael,
Antunes Maria F.,
Kohn Rodrigo,
Rombaldi Airton J.,
Ribeiro Larissa,
Oses Jean P.,
Ferreira Gustavo D.,
Araújo Aline M.,
Boff Isis F.,
Böhlke Maristela
Publication year - 2020
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12793
Subject(s) - medicine , hemodialysis , crossover study , urea , blood flow restriction , dialysis adequacy , renal function , urology , cardiology , gastroenterology , pathology , chemistry , biochemistry , alternative medicine , resistance training , placebo
Hemodialysis (HD) increases the lifespan of chronic kidney disease (CKD) patients. However, HD is only partially effective in replacing renal function. The aim of this study is to compare HD adequacy between sessions with intradialytic exercise with or without blood flow restriction (BFR) with sessions without exercise. Methods A crossover study including 22 adult CKD patients on HD. The patients were assigned to BFR (n = 11) or exercise alone group (n = 11). Each patient was submitted to four HD sessions (two with exercise and two control sessions). HD adequacy was assessed by equilibrated Kt/V‐urea (eKT/V), single‐pool Kt/V‐urea (sp‐Kt/V), urea and phosphorus rebound, urea reduction ratio (URR) and removal of urea and phosphorus in dialysate. Findings BFR exercise improved eKt/V and sp‐Kt/V (1.32 ± 0.21 vs. 1.10 ± 0.16 for control, P < 0.001; 1.53 ± 0.26 vs. 1.27 ± 0.19 for control, P < 0.001, respectively) and URR (72.5 ± 5.4% vs. 66.1 ± 7.7% for control, P < 0.001). No difference in eKt/V, sp‐Kt/V or URR could be detected between exercise alone and control HD sessions. Urea rebound was lower in BFR exercise vs. control sessions (−8.9 ± 9.1% vs. 30.7 ± 12.8%, P < 0.01) and exercise alone vs. control sessions (13.3 ± 29.0% vs. 42.4 ± 15.3%, P < 0.01). Phosphorus rebound was marginally lower in exercise vs. control sessions (14.4 ± 19.1% vs. 28.4 ± 22.1%, P = 0.18). Urea and phosphorus mass removal in dialysate were marginally higher in exercise vs. control sessions (42.2 ± 19.4 g vs. 35.7 ± 12.5 g, P = 0.24; 912.1 ± 360.9 mg vs. 778.6 ± 245.1 mg, P = 0.28). Conclusions Intradialytic exercise with BFR was more effective than standard exercise in increasing HD adequacy.