Effectiveness of Resistance Intradialytic Exercise Compared to Aerobic Intradialytic Exercise for Patients With Chronic Kidney Disease: A Randomized Controlled Clinical Trial.

BACKGROUND

Patients with chronic kidney disease undergoing hemodialysis commonly experience reduced physical function, fatigue, poor sleep quality, and impaired health-related quality of life. Intradialytic exercise has been proposed as a non-pharmacological strategy to improve these outcomes.

METHODS

Randomized clinical trial with 35 hemodialysis patients randomly allocated to a resistance group (RG) or aerobic group (AG). Exercises were performed during hemodialysis for 12 weeks. The primary outcome was handgrip strength (HGS). Secondary outcomes included the 30-second sit-to-stand test (30sec-STS), gait speed (GS), frailty, fatigue, sleep quality, and health-related quality of life (HRQL).

RESULTS

In intragroup analyses, RG improved HGS (MD: 2.4; 95% CI: 0.3-4.5), 30sec-STS, GS, mental fatigue, and sleep quality, whereas AG improved 30sec-STS, GS, and HRQL measured by EQ-VAS. In intergroup analyses, AG was more effective than RG in reducing general fatigue (MD: 2.2; 95% CI: 0.4-4.0) and improving HRQL utility (MD: -0.04; 95% CI: -0.10 to -0.04). No significant between-group differences were observed for HGS or the other outcomes. No adverse events or harms were reported.

CONCLUSIONS

Resistance and aerobic intradialytic exercise were both feasible and safe. Resistance exercise improved handgrip strength within-group; however, no significant between-group difference was observed for handgrip strength (the primary outcome). Aerobic exercise was more effective in improving general fatigue and health-related quality of life.