The effects of intradialytic exercise on hemodialysis adequacy: A systematic review.

Allbwn ymchwil: Cyfraniad at gyfnodolynErthygl adolygu

Fersiynau electronig

Dogfennau

  • 2019 Dialysis_Adequacy

    Llawysgrif awdur wedi’i dderbyn, 449 KB, dogfen-PDF

    Embargo yn dod i ben: 9/04/20

Dangosydd eitem ddigidol (DOI)

  • D.L. Kirkman
    Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
  • Matthew Scott
    Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia
  • Jason Kidd
    Department of Internal Medicine, Division of Nephrology, Virginia Commonwealth University, Richmond, Virginia
  • Jamie Macdonald
Dialysis adequacy is an independent predictor of high mortality rates in hemodialysis patients. Intradialytic exercise is a potential strategy to increase uremic solute removal by increasing blood flow to low perfusion tissue beds. The purpose of this review is to establish the efficacy of intradialytic exercise for hemodialysis adequacy. Additionally, this review aims to provide practical information to aid health care professionals implement intradialytic exercise for dialysis adequacy. Database and hand searches identified 15 published interventional studies that implemented intradialytic exercise for dialysis adequacy as a primary outcome measure in adult maintenance hemodialysis patients. Data pertaining to dialytic solute clearance of urea, creatinine, beta2 microglobulin, phosphate, and potassium were extracted. Mean differences, normalized to percentages, and effect sizes were calculated and reported. The current data pertaining to the use of intradialytic exercise for improving dialysis adequacy in terms of Kt/Vurea or small molecule uremic toxin clearance are equivocal. Limited data showed that intradialytic exercise has no effect middle molecule toxin (beta2 microglobulin) clearance. Intradialytic exercise favored increased phosphate removal showing medium to large effects for reduced serum concentrations, reduced rebound and increased clearance. In summary, supervised light to moderate intradialytic aerobic cycling appears to be beneficial for increasing phosphate removal and may be an adjunct therapy for patients failing to meet clinical phosphate targets. Further work is required to establish the effect of intradialytic exercise on Kt/Vurea and other middle molecule and protein bound solutes. Research aimed at establishing the most effective exercise prescription for improved solute clearance is warranted.
Iaith wreiddiolSaesneg
Tudalennau (o-i)368-378
Nifer y tudalennau11
CyfnodolynSeminars in Dialysis
Cyfrol32
Rhif y cyfnodolyn4
Dyddiad ar-lein cynnar9 Ebr 2019
Dynodwyr Gwrthrych Digidol (DOIs)
StatwsCyhoeddwyd - Gorff 2019
Gweld graff cysylltiadau