Intradialytic exercise (IDE) has been shown to benefit dialysis efficacy; however, the effect of IDE intensity is unknown. Dialyzer urea clearance (K urea, mL/min) was significantly greater during both IDE protocols (55% and 70% maximal heart rate, HRmax), compared with no IDE (p < 0.05). No significant difference in K urea was found between IDE protocols (55% vs. 70% HRmax) (p > 0.05). Results show that higher intensity IDE has no additional benefit on K urea.Key words: exercise, intensity, end-stage kidney disease, hemodialysis, urea, heart rate.Résumé : L'exercice physique intradialyse (« IDE ») améliore, documentation à l'appui, l'efficacité de la dialyse; toutefois, on ne connait pas l'effet de l'intensité de l'IDE. La clairance de l'urée à la dialyse (K urée, mL/min) est significativement supérieure durant les deux protocoles IDE (55 % et 70 % de la fréquence cardiaque maximale, « HRmax ») comparativement à l'absence d'IDE (p < 0,05). On ne note pas de différence significative de K urée entre les deux protocoles d'IDE (55 % vs 70 % HRmax, p > 0,05). D'après les résultats, une plus grande intensité d'IDE n'apporte pas de bénéfice additionnel de K urée. [Traduit par la Rédaction]Mots-clés : exercice physique, intensité, insuffisance rénale terminale, hémodialyse, urée, fréquence cardiaque.

Aims The most appropriate timing of exercise therapy to improve cardiorespiratory fitness (CRF) among patients initiating chemotherapy is not known. The effects of exercise therapy administered during, following, or during and following chemotherapy were examined in patients with breast cancer. Methods and results Using a parallel-group randomized trial design, 158 inactive women with breast cancer initiating (neo)adjuvant chemotherapy were allocated to receive (1:1 ratio): usual care or one of three exercise regimens—concurrent (during chemotherapy only), sequential (after chemotherapy only), or concurrent and sequential (continuous) (n = 39/40 per group). Exercise consisted of treadmill walking three sessions/week, 20–50 min at 55%–100% of peak oxygen consumption (VO2peak) for ≈16 (concurrent, sequential) or ≈32 (continuous) consecutive weeks. VO2peak was evaluated at baseline (pre-treatment), immediately post-chemotherapy, and ≈16 weeks after chemotherapy. In intention-to-treat analysis, there was no difference in the primary endpoint of VO2peak change between concurrent exercise and usual care during chemotherapy vs. VO2peak change between sequential exercise and usual care after chemotherapy [overall difference, −0.88 mL O2·kg−1·min−1; 95% confidence interval (CI): −3.36, 1.59, P = 0.48]. In secondary analysis, continuous exercise, approximately equal to twice the length of the other regimens, was well-tolerated and the only strategy associated with significant improvements in VO2peak from baseline to post-intervention (1.74 mL O2·kg−1·min−1, P &lt; 0.001). Conclusion There was no statistical difference in CRF improvement between concurrent vs. sequential exercise therapy relative to usual care in women with primary breast cancer. The promising tolerability and CRF benefit of ≈32 weeks of continuous exercise therapy warrant further evaluation in larger trials.

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