Effect of intradialytic aerobic exercise intervention on dialysis adequacy and quality of life in patients with end-stage kidney disease undergoing hemodialysis at Dr. Sardjito General Hospital, Indonesia.

IF 1.8 4区 医学 Q3 UROLOGY & NEPHROLOGY International Urology and Nephrology Pub Date : 2024-11-01 Epub Date: 2024-06-08 DOI:10.1007/s11255-024-04100-x
Siti Nur Rohmah, Metalia Puspitasari, Heru Prasanto, Yulia Wardhani, Iri Kuswadi, Andika Dhamarjati
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Abstract

Background: End-stage kidney disease (ESKD) carries a significant financial burden due to the need for hemodialysis (HD). Many HD patients do not achieve optimal dialysis, particularly in developing countries like Indonesia where HD is performed twice a week. To answer this issue, a study was conducted at Dr. Sardjito hospital, Indonesia to investigate the effectiveness of intradialysis aerobic exercise in improving dialysis adequacy and quality of life in conventional HD patients.

Methods: This study is an experimental design with a pre-test-post-test control group. ESKD with HD patient was divided into treatment and control groups. The intervention group was subjected to 30 min of intradialysis aerobic exercise using an ergocycle within the first 2 h of the HD sessions, while the control group received regular care. Both groups were followed for 12 weeks. Dialysis adequacy is measured using Kt/V and Urea Reduction Ratio (URR). Quality of life is assessed using KDQOL-36 questionnaire.

Results: There was a significant increase in Kt/V and URR (%) in the intervention group compared to the control group, (0.122 ± 0.151 vs  - 0.135 ± 0.176, p < 0.001) and (2.627 ± 4.634 vs  - 2.620 ± 3.949, p < 0.001), respectively. In addition, quality of life also improved significantly with KDQOL-36 summary score was significantly higher 73.47 (39.44-89.31) to 80.97 (43.06-92.36); p = 0.007) in the intervention group. Multivariate analysis showed that intradialysis exercise (p = 0.001), female gender (p = 0.044), and intradialysis diastolic pressure (p = 0.018) can significantly affect Kt/V changes.

Conclusion: Intradialytic aerobic exercise for 12 weeks effectively improves dialysis adequacy and quality of life in routine HD patients. This suggests an opportunity for routine deployment, especially when HD resources are limited. However, further studies are needed to investigate additional efficacy aspects and improve exercise protocols for specific ESKD patients.

Trial registration: TCTR202403270002 (retrospectively registered on March 27, 2024).

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在印度尼西亚萨吉托博士综合医院接受血液透析的终末期肾病患者,透析内有氧运动干预对透析充分性和生活质量的影响。
背景:终末期肾病(ESKD)因需要进行血液透析(HD)而带来了巨大的经济负担。许多血液透析患者无法达到最佳透析效果,特别是在印度尼西亚等发展中国家,血液透析每周进行两次。为了回答这个问题,印度尼西亚的 Sardjito 医生医院开展了一项研究,调查透析内有氧运动在改善传统血液透析患者透析充分性和生活质量方面的效果:本研究采用实验设计,分为前测-后测对照组。将 ESKD 合并 HD 患者分为治疗组和对照组。干预组在血液透析疗程的前 2 小时内使用电动自行车进行 30 分钟的透析内有氧运动,而对照组则接受常规护理。两组患者均接受了 12 周的随访。透析充分性采用 Kt/V 和尿素还原率 (URR) 进行测量。生活质量采用 KDQOL-36 问卷进行评估:结果:与对照组相比,干预组的 Kt/V 和尿素还原率(%)有明显提高(0.122 ± 0.151 vs - 0.135 ± 0.176,p 结论:干预组的 Kt/V 和尿素还原率(%)有明显提高(0.122 ± 0.151 vs - 0.135 ± 0.176,p):持续 12 周的椎管内有氧运动可有效改善常规 HD 患者的透析充分性和生活质量。这为常规部署提供了机会,尤其是在血液透析资源有限的情况下。然而,还需要进一步的研究来调查更多的疗效方面,并改进针对特定 ESKD 患者的运动方案:试验注册:TCTR202403270002(2024 年 3 月 27 日回顾性注册)。
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来源期刊
International Urology and Nephrology
International Urology and Nephrology 医学-泌尿学与肾脏学
CiteScore
3.40
自引率
5.00%
发文量
329
审稿时长
1.7 months
期刊介绍: International Urology and Nephrology publishes original papers on a broad range of topics in urology, nephrology and andrology. The journal integrates papers originating from clinical practice.
期刊最新文献
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