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08-06-2024 | Chronic Kidney Disease | Nephrology – Original Paper

Effect of intradialytic aerobic exercise intervention on dialysis adequacy and quality of life in patients with end-stage kidney disease undergoing hemodialysis at Dr. Sardjito General Hospital, Indonesia

Authors: Siti Nur Rohmah, Metalia Puspitasari, Heru Prasanto, Yulia Wardhani, Iri Kuswadi, Andika Dhamarjati

Published in: International Urology and Nephrology

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Abstract

Background

End-stage kidney disease (ESKD) carries a significant financial burden due to the need for hemodialysis (HD). Many HD patients do not achieve optimal dialysis, particularly in developing countries like Indonesia where HD is performed twice a week. To answer this issue, a study was conducted at Dr. Sardjito hospital, Indonesia to investigate the effectiveness of intradialysis aerobic exercise in improving dialysis adequacy and quality of life in conventional HD patients.

Methods

This study is an experimental design with a pre-test–post-test control group. ESKD with HD patient was divided into treatment and control groups. The intervention group was subjected to 30 min of intradialysis aerobic exercise using an ergocycle within the first 2 h of the HD sessions, while the control group received regular care. Both groups were followed for 12 weeks. Dialysis adequacy is measured using Kt/V and Urea Reduction Ratio (URR). Quality of life is assessed using KDQOL-36 questionnaire.

Results

There was a significant increase in Kt/V and URR (%) in the intervention group compared to the control group, (0.122 ± 0.151 vs  – 0.135 ± 0.176, p < 0.001) and (2.627 ± 4.634 vs  – 2.620 ± 3.949, p < 0.001), respectively. In addition, quality of life also improved significantly with KDQOL-36 summary score was significantly higher 73.47 (39.44–89.31) to 80.97 (43.06–92.36); p = 0.007) in the intervention group. Multivariate analysis showed that intradialysis exercise (p = 0.001), female gender (p = 0.044), and intradialysis diastolic pressure (p = 0.018) can significantly affect Kt/V changes.

Conclusion

Intradialytic aerobic exercise for 12 weeks effectively improves dialysis adequacy and quality of life in routine HD patients. This suggests an opportunity for routine deployment, especially when HD resources are limited. However, further studies are needed to investigate additional efficacy aspects and improve exercise protocols for specific ESKD patients.

Trial Registration

TCTR202403270002 (retrospectively registered on March 27, 2024).
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Metadata
Title
Effect of intradialytic aerobic exercise intervention on dialysis adequacy and quality of life in patients with end-stage kidney disease undergoing hemodialysis at Dr. Sardjito General Hospital, Indonesia
Authors
Siti Nur Rohmah
Metalia Puspitasari
Heru Prasanto
Yulia Wardhani
Iri Kuswadi
Andika Dhamarjati
Publication date
08-06-2024
Publisher
Springer Netherlands
Published in
International Urology and Nephrology
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-024-04100-x
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