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

Abstract

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.

Serum heart-type fatty acid-binding protein decreases and soluble isoform of suppression of tumorigenicity 2 increases significantly by long-term physical activity

“…Concerning H-FABP, Arı et al could show that H-FABP levels do not increase due to myocardial ischemia induced by (acute) exercise stress testing in patients with CAD27 and similar results were found by Sbarouni et al 28. A further study in patients with end-stage renal disease and haemodialysis showed that intradialytic exercise (5-minute warm-up followed by a 30-minute bout of intradialytic exercise using a specially designed cycle ergometer) had no significant influence on H-FABP levels 29. A small study investigated the influence of a 21 km run in 10 healthy male subjects and found a significant increase in H-FABP levels after the run and H-FABP levels returned to baseline 6 hours after the run 30.…”

The Clinical Significance of Physical Activity in Maintenance Dialysis Patients

“…Previous studies showed favorable effects of physical activity in dialysis patients; however, these have mainly focused on Western populations or mortality only [12-23]. Few studies have comprehensively assessed the effects of physical activity on various factors, including HRQoL, frailty, disability, exhaustion, and mortality, in Asian populations.…”

Comparison of Muscle Mass Indices Using Computed Tomography or Dual X-Ray Absorptiometry for Predicting Physical Performance in Hemodialysis Patients

“…HD patients have higher insulin resistance and prevalence of DM than the general population, resulting in changes in body composition [23-25]. In HD patients, various factors including inflammation lead to insulin resistance, which is associated with increased catabolism and decreased anabolism in the muscles [26, 27].…”