Intradialytic exercise with blood flow restriction: Something to add to hemodialysis adequacy? Findings from a crossover study

Introduction Hemodialysis (HD) increases the lifespan of chronic kidney disease (CKD) patients. However, HD is only partially effective in replacing renal function. The aim of this study is to compare HD adequacy between sessions with intradialytic exercise with or without blood flow restriction (BFR) with sessions without exercise. Methods A crossover study including 22 adult CKD patients on HD. The patients were assigned to BFR (n = 11) or exercise alone group (n = 11). Each patient was submitted to four HD sessions (two with exercise and two control sessions). HD adequacy was assessed by equilibrated Kt/V‐urea (eKT/V), single‐pool Kt/V‐urea (sp‐Kt/V), urea and phosphorus rebound, urea reduction ratio (URR) and removal of urea and phosphorus in dialysate. Findings BFR exercise improved eKt/V and sp‐Kt/V (1.32 ± 0.21 vs. 1.10 ± 0.16 for control, P