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 (BF...
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| Veröffentlicht in: | Hemodialysis international 2020-01, Vol.24 (1), p.71-78 |
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| creator | Dias, Etiene C. Orcy, Rafael Antunes, Maria F. Kohn, Rodrigo Rombaldi, Airton J. Ribeiro, Larissa Oses, Jean P. Ferreira, Gustavo D. Araújo, Aline M. Boff, Isis F. Böhlke, Maristela |
| description | 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 |
| doi_str_mv | 10.1111/hdi.12793 |
| format | Article |
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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 < 0.001; 1.53 ± 0.26 vs. 1.27 ± 0.19 for control, P < 0.001, respectively) and URR (72.5 ± 5.4% vs. 66.1 ± 7.7% for control, P < 0.001). No difference in eKt/V, sp‐Kt/V or URR could be detected between exercise alone and control HD sessions. Urea rebound was lower in BFR exercise vs. control sessions (−8.9 ± 9.1% vs. 30.7 ± 12.8%, P < 0.01) and exercise alone vs. control sessions (13.3 ± 29.0% vs. 42.4 ± 15.3%, P < 0.01). Phosphorus rebound was marginally lower in exercise vs. control sessions (14.4 ± 19.1% vs. 28.4 ± 22.1%, P = 0.18). Urea and phosphorus mass removal in dialysate were marginally higher in exercise vs. control sessions (42.2 ± 19.4 g vs. 35.7 ± 12.5 g, P = 0.24; 912.1 ± 360.9 mg vs. 778.6 ± 245.1 mg, P = 0.28).
Conclusions
Intradialytic exercise with BFR was more effective than standard exercise in increasing HD adequacy.</description><identifier>ISSN: 1492-7535</identifier><identifier>EISSN: 1542-4758</identifier><identifier>DOI: 10.1111/hdi.12793</identifier><identifier>PMID: 31612630</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>adequacy of dialysis ; blood flow restriction ; exercise ; Life Sciences & Biomedicine ; Science & Technology ; technical hemodialysis ; Urology & Nephrology</subject><ispartof>Hemodialysis international, 2020-01, Vol.24 (1), p.71-78</ispartof><rights>2019 International Society for Hemodialysis</rights><rights>2019 International Society for Hemodialysis.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>13</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000489819400001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c3603-1db80dcd731d6f72aab2812ceac34ab8959f6d2006114f69a871e51ae0652c683</citedby><cites>FETCH-LOGICAL-c3603-1db80dcd731d6f72aab2812ceac34ab8959f6d2006114f69a871e51ae0652c683</cites><orcidid>0000-0001-9372-3475 ; 0000-0002-6707-814X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhdi.12793$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhdi.12793$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,28253,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31612630$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dias, Etiene C.</creatorcontrib><creatorcontrib>Orcy, Rafael</creatorcontrib><creatorcontrib>Antunes, Maria F.</creatorcontrib><creatorcontrib>Kohn, Rodrigo</creatorcontrib><creatorcontrib>Rombaldi, Airton J.</creatorcontrib><creatorcontrib>Ribeiro, Larissa</creatorcontrib><creatorcontrib>Oses, Jean P.</creatorcontrib><creatorcontrib>Ferreira, Gustavo D.</creatorcontrib><creatorcontrib>Araújo, Aline M.</creatorcontrib><creatorcontrib>Boff, Isis F.</creatorcontrib><creatorcontrib>Böhlke, Maristela</creatorcontrib><title>Intradialytic exercise with blood flow restriction: Something to add to hemodialysis adequacy? Findings from a crossover study</title><title>Hemodialysis international</title><addtitle>HEMODIAL INT</addtitle><addtitle>Hemodial Int</addtitle><description>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 < 0.001; 1.53 ± 0.26 vs. 1.27 ± 0.19 for control, P < 0.001, respectively) and URR (72.5 ± 5.4% vs. 66.1 ± 7.7% for control, P < 0.001). No difference in eKt/V, sp‐Kt/V or URR could be detected between exercise alone and control HD sessions. Urea rebound was lower in BFR exercise vs. control sessions (−8.9 ± 9.1% vs. 30.7 ± 12.8%, P < 0.01) and exercise alone vs. control sessions (13.3 ± 29.0% vs. 42.4 ± 15.3%, P < 0.01). Phosphorus rebound was marginally lower in exercise vs. control sessions (14.4 ± 19.1% vs. 28.4 ± 22.1%, P = 0.18). Urea and phosphorus mass removal in dialysate were marginally higher in exercise vs. control sessions (42.2 ± 19.4 g vs. 35.7 ± 12.5 g, P = 0.24; 912.1 ± 360.9 mg vs. 778.6 ± 245.1 mg, P = 0.28).
Conclusions
Intradialytic exercise with BFR was more effective than standard exercise in increasing HD adequacy.</description><subject>adequacy of dialysis</subject><subject>blood flow restriction</subject><subject>exercise</subject><subject>Life Sciences & Biomedicine</subject><subject>Science & Technology</subject><subject>technical hemodialysis</subject><subject>Urology & Nephrology</subject><issn>1492-7535</issn><issn>1542-4758</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><recordid>eNqNkUtv1TAQhS0E6osu-APIS1CV1o_EsdlU1W1Lr1SJBbCOHHvCNUri1nZ6yaa_vb4PukPCmxmNvjk6c4zQB0rOaX4XK-vOKasVf4OOaFWyoqwr-Tb3pWJFXfHqEB3H-JsQRgkRB-iQU0GZ4OQIPS_HFLR1up-TMxj-QDAuAl67tMJt773FXe_XOEBMwZnk_PgFf_cDpJUbf-HksbZ2U1Yw-K1MdDHP4HHSZr7Et260GYy4C37AGpvgY_RPEHBMk53fo3ed7iOc7usJ-nl782NxV9x_-7pcXN0XhgvCC2pbSayxNadWdDXTumWSMgPa8FK3UlWqE5bl4ygtO6G0rClUVAMRFTNC8hP0aaf7EPzjlG9pBhcN9L0ewU-xYZxUtSqVFBn9vEO3VgN0zUNwgw5zQ0mzibvJcTfbuDP7cS87tQPYV_Jvvhk42wFraH0XjYPRwCtGCCmlklSVuSM00_L_6YVLevMdCz-NKa9e7FddD_O_LTd318ud9xcoU6w0</recordid><startdate>202001</startdate><enddate>202001</enddate><creator>Dias, Etiene C.</creator><creator>Orcy, Rafael</creator><creator>Antunes, Maria F.</creator><creator>Kohn, Rodrigo</creator><creator>Rombaldi, Airton J.</creator><creator>Ribeiro, Larissa</creator><creator>Oses, Jean P.</creator><creator>Ferreira, Gustavo D.</creator><creator>Araújo, Aline M.</creator><creator>Boff, Isis F.</creator><creator>Böhlke, Maristela</creator><general>John Wiley & Sons, Inc</general><general>Wiley</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9372-3475</orcidid><orcidid>https://orcid.org/0000-0002-6707-814X</orcidid></search><sort><creationdate>202001</creationdate><title>Intradialytic exercise with blood flow restriction: Something to add to hemodialysis adequacy? Findings from a crossover study</title><author>Dias, Etiene C. ; Orcy, Rafael ; Antunes, Maria F. ; Kohn, Rodrigo ; Rombaldi, Airton J. ; Ribeiro, Larissa ; Oses, Jean P. ; Ferreira, Gustavo D. ; Araújo, Aline M. ; Boff, Isis F. ; Böhlke, Maristela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3603-1db80dcd731d6f72aab2812ceac34ab8959f6d2006114f69a871e51ae0652c683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>adequacy of dialysis</topic><topic>blood flow restriction</topic><topic>exercise</topic><topic>Life Sciences & Biomedicine</topic><topic>Science & Technology</topic><topic>technical hemodialysis</topic><topic>Urology & Nephrology</topic><toplevel>online_resources</toplevel><creatorcontrib>Dias, Etiene C.</creatorcontrib><creatorcontrib>Orcy, Rafael</creatorcontrib><creatorcontrib>Antunes, Maria F.</creatorcontrib><creatorcontrib>Kohn, Rodrigo</creatorcontrib><creatorcontrib>Rombaldi, Airton J.</creatorcontrib><creatorcontrib>Ribeiro, Larissa</creatorcontrib><creatorcontrib>Oses, Jean P.</creatorcontrib><creatorcontrib>Ferreira, Gustavo D.</creatorcontrib><creatorcontrib>Araújo, Aline M.</creatorcontrib><creatorcontrib>Boff, Isis F.</creatorcontrib><creatorcontrib>Böhlke, Maristela</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hemodialysis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dias, Etiene C.</au><au>Orcy, Rafael</au><au>Antunes, Maria F.</au><au>Kohn, Rodrigo</au><au>Rombaldi, Airton J.</au><au>Ribeiro, Larissa</au><au>Oses, Jean P.</au><au>Ferreira, Gustavo D.</au><au>Araújo, Aline M.</au><au>Boff, Isis F.</au><au>Böhlke, Maristela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intradialytic exercise with blood flow restriction: Something to add to hemodialysis adequacy? Findings from a crossover study</atitle><jtitle>Hemodialysis international</jtitle><stitle>HEMODIAL INT</stitle><addtitle>Hemodial Int</addtitle><date>2020-01</date><risdate>2020</risdate><volume>24</volume><issue>1</issue><spage>71</spage><epage>78</epage><pages>71-78</pages><issn>1492-7535</issn><eissn>1542-4758</eissn><abstract>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 < 0.001; 1.53 ± 0.26 vs. 1.27 ± 0.19 for control, P < 0.001, respectively) and URR (72.5 ± 5.4% vs. 66.1 ± 7.7% for control, P < 0.001). No difference in eKt/V, sp‐Kt/V or URR could be detected between exercise alone and control HD sessions. Urea rebound was lower in BFR exercise vs. control sessions (−8.9 ± 9.1% vs. 30.7 ± 12.8%, P < 0.01) and exercise alone vs. control sessions (13.3 ± 29.0% vs. 42.4 ± 15.3%, P < 0.01). Phosphorus rebound was marginally lower in exercise vs. control sessions (14.4 ± 19.1% vs. 28.4 ± 22.1%, P = 0.18). Urea and phosphorus mass removal in dialysate were marginally higher in exercise vs. control sessions (42.2 ± 19.4 g vs. 35.7 ± 12.5 g, P = 0.24; 912.1 ± 360.9 mg vs. 778.6 ± 245.1 mg, P = 0.28).
Conclusions
Intradialytic exercise with BFR was more effective than standard exercise in increasing HD adequacy.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31612630</pmid><doi>10.1111/hdi.12793</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9372-3475</orcidid><orcidid>https://orcid.org/0000-0002-6707-814X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; Wiley Online Library All Journals |
| subjects | adequacy of dialysis blood flow restriction exercise Life Sciences & Biomedicine Science & Technology technical hemodialysis Urology & Nephrology |
| title | Intradialytic exercise with blood flow restriction: Something to add to hemodialysis adequacy? Findings from a crossover study |
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