RenalWEB Dialysis Discussion Boards
  RenalWEB Dialysis Nephrology Kidney Discussion Boards
  General News
  Exercise for Dialysis Patients

Post New Topic  Post A Reply
profile | register | preferences | faq | search

UBBFriend: Email This Page to Someone! next newest topic | next oldest topic
Author Topic:   Exercise for Dialysis Patients
Gary Peterson
posted 05-29-2001 09:03 AM     Click Here to See the Profile for Gary Peterson   Click Here to Email Gary Peterson     Edit/Delete Message   Reply w/Quote

Benefits & Protective Effect of Exercise

October 5, 2004 - The October issue of the Journal of the American Society of Nephrology (JASN) contains an article on the impact of exercise on hemodialysis patients.

"Impact of an Exercise Program on Arterial Stiffness and Insulin Resistance in Hemodialysis Patients" - abstract from JASN

February 27, 2004 - The Jan/Feb issue of Nephrology Nursing Journal (NNJ) contains two article on exercise and hemodialysis patients:

"Perceived Barriers and Motivators to Exercise in Hemodialysis Patients" - abstract from NNJ (link is no longer available)

"Determinants of Exercise Encouragement Practices in Hemodialysis Staff" - abstract from NNJ

(link is no longer available)

January 13, 2004 - A study published in Kidney International (KI) shows not only is exercise that predictor of survival for dialysis patients, but it may also serve as an intervention to improve survival.

"Exercise capacity as a predictor of survival among ambulatory patients with end-stage renal disease" - abstract from KI

November 12, 2003 - Exercise's role in preventing and treating common health disorders such as heart disease, certain cancers and diabetes is fairly well understood. However, exercise also can help improve physical function and quality of life with many other, less common, health problems, such as end stage renal disease (ESRD). Article from the Detroit News.

January 2, 2003 - The January 2003 issue of the American Journal of Kidney Diseases (AJKD) contains a study on the low rates of exercise counseling among nephrologists.

"Exercise counseling practices among nephrologists caring for patients on dialysis" - abstract from AJKD

December 19, 2002 - The January 2003 issue of Kidney International (KI) contains a study on muscle atrophy (shrinking) in hemodialysis patients. The study quantifies the extent of atrophy in the lower extremity muscles, determines whether defects in muscle specific strength (force per unit mass) or central nervous system (CNS) activation are present, and assesses the relationship between muscle size and physical performance in a group of patients on hemodialysis.
"Muscle atrophy in patients receiving hemodialysis: Effects on muscle strength, muscle quality, and physical function" - abstract from KI

Here is a full exercise program for dialysis patients from the LifeOptions web site. "Exercise" is one of the "five E's" of renal rehabilitation.

August 7, 2002 - Study after study shows the benefits of exercise for ESRD patients. Encouraging and counseling patients to exercise, however, seem to have little effect.

The latest issue of Annals of Internal Medicine has two full-text articles on physical activity/exercise.

"Behavioral Counseling in Primary Care To Promote Physical Activity: Recommendation and Rationale" - Clinical Guideline from U.S. Preventive Services Task Force.

"Does Counseling by Clinicians Improve Physical Activity? A Summary of the Evidence for the U.S. Preventive Services Task Force" - Clinical GuidelineThere is insufficient evidence to determine whether counseling patients in primary care settings to promote physical activity leads to sustained increases in physical activity among adult patients.

An article in this month's American Journal of Kidney Diseases on renal rehabilitation found that of five categories of rehabilitation activities (encouragement, education, exercise, employment, and evaluation), exercise interventions were the least often implemented activities. Here is the abstract of "Renal rehabilitation and improved patient outcomes in Texas dialysis facilities".

Earlier this year, Toronto Rehab and University Health Network (UHN) formed an innovative partnership to provide enhanced hemodialysis treatment for geriatric rehabilitation and complex continuing care patients. Press release from Toronto Rehab. (link is no longer available)

This month's issue of American Journal of Kidney Diseases has an abstract on exercise for ESRD patients entitled, "Resistance training improves strength and functional measures in patients with end-stage renal disease". Its conclusion:

"Resistance training can be used safely to increase strength and functional capacity in stable hemodialysis patients."

March 29, 2002 - The April 2002 issue of the American Journal of Kidney Diseases has an abstract entitled, "Exercise during hemodialysis decreases the use of antihypertensive medications".
"No serious adverse events were reported. Predialysis and postdialysis blood pressures were not statistically different between the two groups at month 0 or month 6, but 13 (54%) in the exercise group had a reduction in antihypertensive medication versus 4 (12.5%) in the control group (P = 0.008). The average relative benefit of exercise was a 36% reduction in antihypertensive medications (P = 0.018) with an average annual cost savings of $885/patient-year (P = 0.005) in the exercise group. Stationary cycling is safe during hemodialysis and can lead to significant reductions in blood pressure medication use and cost savings, justifying the initial capital cost of equipment and small incremental increase in staff time."

February 12, 2002 - The February 2002 issue of the American Journal of Kidney Diseases has an abstract entitled, "Effects of exercise training plus normalization of hematocrit on exercise capacity and health-related quality of life".
"In conclusion, the exercise limitation in hemodialysis patients is not a straightforward physiologic mechanism. Other contributors to limited exercise tolerance could include autonomic dysfunction, vascular dysfunction, muscle dysfunction caused by chronic metabolic acidosis, or hyperparathyroidism, and certainly the long-term effects of physical inactivity. Exercise training for 5 months had a significant effect on peak (oxygen intake) at both usual care and normalized hematocrit levels, but failed to normalize peak (oxygen intake). The normalization of hematocrit did not further improve peak (oxygen intake), even with exercise training. In addition to the overall benefit for maximal exercise, exercise training improved self-reported physical functioning. More appropriate tests of the impact of exercise training are needed, as are further studies of the mechanisms of limitations to maximal exercise in hemodialysis patients."

Here is another abstract related to exercise and hemodialysis patients entitled, "Influence of the Alpha-1-Adrenergic Receptor Blocker Doxazosin on Exercise-Induced Hyperkalemia in Hemodialysis Patients" - abstract from Kidney and Blood Pressure Research

January 8, 2002 - The January 2002 issue of the American Journal of Kidney Diseases has an abstract entitled, "Clinical and demographic predictors of exercise capacity in end-stage renal disease".

"In conclusion, substantial exercise limitation was shown in this large series of patients with ESRD. Despite an inherent bias toward healthier hemodialysis patients, more than half the patients studied had peak VO2 values in a range associated with impairment of independent function in other clinical populations. Factors that predict the degree of exercise limitation within the group as a whole include variables reflecting clinical status and medical treatment (serum albumin and hemoglobin concentrations) and comorbid diagnoses (diabetes and chronic heart failure), as well as demographic factors. The principle findings from this analysis thus support the concept that nutritional status and support of hemoglobin concentration contribute significantly to preserving functional capacity and, by inference, reducing impairment in patients with ESRD."

September 6, 2001 - Here is an article by Dr. Steven Keteyian, program director of preventive cardiology at the Henry Ford Heart & Vascular Institute in Detroit, about the benefits of exercise for end-stage renal disease patients.

June 3, 2001 - Another arguments for implementing an exercise program:

"Twelve Weeks of Exercise Training Increases Muscle Function and Walking Capacity in Elderly Predialysis Patients and Healthy Subjects" - abstract from Nephron May 2001 issue

May 29, 2001 - The protective effect of exercise seems to apply to everyone, regardless of age, gender, smoking and additional diseases. This conclusion comes from a study showing that adults who suffer from chronic health problems such as high blood pressure or heart disease can lower their short-term risk of death by exercising for at least 30 minutes a week.

Here is the abstract of the paper, "Physical Inactivity and Short-term All-Cause Mortality in Adults With Chronic Disease" - from the Archives of Internal Medicine.

Here is a full exercise program for dialysis patients from the LifeOptions web site. "Exercise" is one of the "five E's" of renal rehabilitation.

Here is a safe and comfortable exercise chair that was co-invented by Richard Sarns, who also developed dialysis machine components.

[This message has been edited by Gary Peterson (edited 12-20-2004).]


All times are ET (US)

next newest topic | next oldest topic

Administrative Options: Close Topic | Archive/Move | Delete Topic
Post New Topic  Post A Reply
Hop to:

Contact Us | RenalWEB Home Page

Ultimate Bulletin Board 5.47e

Copyright 2004. No material on these discussion boards may be reproduced without permission from RenalWEB.