Depression, heart rate variability, and exercise training in dialysis patients

Kouidi, Evangelia; Karagiannis, Vasileios; Grekas, Dimitrios; Iakovides, A.; Kaprinis, George; Tourkantonis, A.; Deligiannis, Asterios

doi:10.1097/hjr.0b013e32833188c4

Cited by 109 publications

(142 citation statements)

References 44 publications

(94 reference statements)

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“…From 1,706 potential studies, 24 RCTs [3,4,5,6,7,8,9,10,11,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32] fulfilled the inclusion criteria. Kouidi et al published two duplicated studies in different magazines [3,17].…”

Section: Resultsmentioning

confidence: 99%

Intradialytic Exercise in Hemodialysis Patients: A Systematic Review and Meta-Analysis

et al. 2014

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Background and Objective: Hemodialysis (HD) patients are more inactive, leading to poor functional capacity and quality of life; this may be reversed with intradialytic exercise training. To systematically evaluate the efficacy and safety of intradialytic exercise for HD patients, we conducted a meta-analysis of the published randomized controlled trials. Data Sources and Methods: Medline, Embase, and Cochrane Central Register of Controlled Trials were systematically searched up to February, 2014. The reference lists of eligible studies and relevant reviews were also checked. Results: 24 studies of 997 patients were included. Compared with control, intradialytic exercise significantly improve Kt/V (SMD = 0.27, 95% CI 0.01-0.53), peak oxygen consumption (VO_2peak) (SMD = 0.53, 95% CI 0.30-0.76), and physical performance of physical function of life (SMD = 0.30, 95% CI 0.04-0.55). However, no significant improvements were found in the mental function of life. There was no significant difference with respect to musculoskeletal and cardiovascular complications between the intradialytic exercise groups and control groups. Further subgroup analysis found that, when the trial duration was more than 6 months, the intervention had significant effects on VO_2peak (SMD = 0.89, 95% CI 0.56-1.22). However, when the trial duration was less than 6 months, the change of VO_2peak was not significant (SMD = 0.19, 95% CI -0.13 to 0.51). Conclusion: Intradialytic exercise can improve Kt/V, VO_2peak, and the physical quality of life, and intradialytic exercise is safe for HD patients. Therefore, we put forward the suggestion that clinical guideline be updated to inform clinicians on the benefits of intradialytic exercise on HD patients. i 2014 S. Karger AG, Basel

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Section: Resultsmentioning

confidence: 99%

Intradialytic Exercise in Hemodialysis Patients: A Systematic Review and Meta-Analysis

et al. 2014

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“…Elsewhere, no serious adverse events have been reported after around 28,000 h of intradialytic exercise [13]. Moreover, ESRD patients who regularly exercise during HD improve heart rate variability, left ventricular ejection fraction and risk rating of sudden cardiac death [39,40,41]. Further research is required to delineate myocardial and vascular function during and after intradialytic exercise and the long-term impact of regular training.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Exercising During Haemodialysis on Blood Pressure, Markers of Cardiac Injury and Systemic Inflammation - Preliminary Results of a Pilot Study

Dungey¹,

Bishop

Young³

et al. 2015

Kidney Blood Press Res

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Background/Aims: Patients requiring haemodialysis have cardiovascular and immune dysfunction. Little is known about the acute effects of exercise during haemodialysis. Exercise has numerous health benefits but in other populations has a profound impact upon blood pressure, inflammation and immune function; therefore having the potential to exacerbate cardiovascular and immune dysfunction in this vulnerable population. Methods: Fifteen patients took part in a randomised-crossover study investigating the effect of a 30-min bout of exercise during haemodialysis compared to resting haemodialysis. We assessed blood pressure, plasma markers of cardiac injury and systemic inflammation and neutrophil degranulation. Results: Exercise increased blood pressure immediately post-exercise; however, 1 hour after exercise blood pressure was lower than resting levels (106±22 vs. 117±25 mm Hg). No differences in h-FABP, cTnI, myoglobin or CKMB were observed between trial arms. Exercise did not alter circulating concentrations of IL-6, TNF-α or IL-1ra nor clearly suppress neutrophil function. Conclusions: This study demonstrates fluctuations in blood pressure during haemodialysis in response to exercise. However, since the fall in blood pressure occurred without evidence of cardiac injury, we regard it as a normal response to exercise superimposed onto the haemodynamic response to haemodialysis. Importantly, exercise did not exacerbate systemic inflammation or immune dysfunction; intradialytic exercise was well tolerated.

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“…Ouzouni et al (2009) reported that 10-month intradialytic exercise training improved QoL in both physical functioning and psychological status in HD patients, and decreased in self-reported depression. In another study, a 1-year exercise training program reduced emotional distress and concomitantly improved cardiac autonomic modulation measured by heart rate variability (HRV) indices (Kouidi et al, 2010). For alternative therapy, Kim et al (2011) reported that 24 HD patients who received individualized acupuncture treatments over 6 consecutive weeks showed significant improvements in some QoL subscales.…”

Section: Non-pharmacological Interventionsmentioning

confidence: 99%

The Psychological Impact of Hemodialysis on Patients with Chronic Renal Failure

Wang¹,

Chen²

2012

Renal Failure - The Facts

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Depression, heart rate variability, and exercise training in dialysis patients

Abstract: Cardiac autonomic modulation seemed to be sensitive to the experience of persistent depression in HD patients. Significantly, exercise training reduced emotional distress and concomitantly improved HRV.

Cited by 109 publications

References 44 publications

Intradialytic Exercise in Hemodialysis Patients: A Systematic Review and Meta-Analysis

Intradialytic Exercise in Hemodialysis Patients: A Systematic Review and Meta-Analysis

The Impact of Exercising During Haemodialysis on Blood Pressure, Markers of Cardiac Injury and Systemic Inflammation - Preliminary Results of a Pilot Study

The Psychological Impact of Hemodialysis on Patients with Chronic Renal Failure

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