Acute effect of exercise on cardiovascular response during dialysis (ACE-HD)
Intradialytic exercise (IDEX, exercise during hemodialysis(HD) treatment) represents a low-cost, easy to administer treatment strategy that could potentially improve cardiovascular (CV) function, physical function and quality of life. However, nephrologists rarely counsel their patients to increase their physical activity levels or to exercise during HD treatment, in part due to a lack of understanding of the safety and efficacy of IDEX. CV response to IDEX in relation to fluid overload warrants further research. Preexisting CV complications predispose the patient to abnormal hemodynamic responses during HD. These often result in adverse events ranging from hypotension to sudden cardiac death.
The aim of this study is to examine the impact of IDEX and its timing during treatment (1st vs 3rd hour) on blood pressure and adverse symptoms in HD patients. This study also incorporates various cardiovascular measures to allow deeper mechanistic understanding of cardiovascular physiology with IDEX including a set of integrated cardiovascular measures functional and structural measures of heart, artery, and autonomic function.
- Cross-over design with 3 randomized conditions.
- Each patient will be asked to undergo three protocols in random order: 1) exercise for 30 minutes beginning 30 minutes into treatment; 2) exercise for 30 minutes beginning 3 hours into treatment; and 3) usual care
- A series of CV measures will be collected before, after and during HD sessions.