Acute Effect of Moderate-Intensity Interval Intradialytic Exercise on Cerebral Oxygenation in Hemodialysis Patients: A Randomized Crossover Trial.

IF 10.3 1区医学 Q1 UROLOGY & NEPHROLOGY Journal of The American Society of Nephrology Pub Date : 2025-03-12 DOI:10.1681/ASN.0000000672

Sho Kojima, Naoto Usui, Akimi Uehata, Akihito Inatsu, Yasuo Chiba, Hisadome Hideki, Yusuke Suzuki, Junichiro Nakata, Atsuhiro Tsubaki

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Abstract

Background: Cognitive dysfunction in hemodialysis (HD) patients is associated with decreased regional cerebral oxygenation (rSO2). Intradialytic exercise improves cognitive function; nonetheless, the acute effect of intradialytic exercise on cerebral circulation remains unknown. This study aimed to evaluate the acute effect of intradialytic exercise on rSO2 during HD.

Methods: This single-center, open-label, randomized crossover trial included 20 HD patients. Patients received the control condition as usual care and the intradialytic exercise condition in random order. The intradialytic exercise condition involved the performance of anaerobic threshold-intensity interval exercise for 35 min. Cerebral oxygenation (rSO2, oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin) in the prefrontal cortex was measured using near-infrared spectroscopy during HD. Cardiovascular responses, including the heart rate, cardiac index, mean arterial pressure, and blood gas, were also assessed. The two conditions were compared using two-way repeated-measures analysis of variance.

Results: The analysis included 16 patients, four of whom were excluded because of artifacts in the cerebral oxygenation data. The rSO2 (P<0.001), oxygenated hemoglobin (P<0.001), and total hemoglobin (P=0.004) showed significant interactions and were significantly increased at end of exercise (rSO2 1.3%, 95%CI [0.5, 2.1]; oxygenated hemoglobin 0.01 mM, 95%CI [0.00, 0.02]; total hemoglobin 0.01 mM, 95%CI [0.00, 0.03]) and 15-min after exercise (rSO2 1.1%, 95%CI [0.2, 2.0]; oxygenated hemoglobin 0.01 mM, 95%CI [0.00, 0.03]; total hemoglobin 0.02 mM, 95%CI [0.00, 0.03]) in the intradialytic exercise condition compared with the control condition. The rSO2 at the end of HD in the control condition was significantly decreased compared with that during pre-HD (-1.5%, 95%CI [-2.7, -0.3]), but not in the intradialytic exercise condition (-1.2%, 95%CI [-2.8, 0.5]).

Conclusions: Intradialytic exercise significantly increased rSO2 during and after exercise and improved rSO2 to the same extent as pre-dialysis.

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来源期刊

Journal of The American Society of Nephrology 医学-泌尿学与肾脏学

CiteScore

22.40

自引率

2.90%

发文量

492

审稿时长

3-8 weeks

期刊介绍： The Journal of the American Society of Nephrology (JASN) stands as the preeminent kidney journal globally, offering an exceptional synthesis of cutting-edge basic research, clinical epidemiology, meta-analysis, and relevant editorial content. Representing a comprehensive resource, JASN encompasses clinical research, editorials distilling key findings, perspectives, and timely reviews. Editorials are skillfully crafted to elucidate the essential insights of the parent article, while JASN actively encourages the submission of Letters to the Editor discussing recently published articles. The reviews featured in JASN are consistently erudite and comprehensive, providing thorough coverage of respective fields. Since its inception in July 1990, JASN has been a monthly publication. JASN publishes original research reports and editorial content across a spectrum of basic and clinical science relevant to the broad discipline of nephrology. Topics covered include renal cell biology, developmental biology of the kidney, genetics of kidney disease, cell and transport physiology, hemodynamics and vascular regulation, mechanisms of blood pressure regulation, renal immunology, kidney pathology, pathophysiology of kidney diseases, nephrolithiasis, clinical nephrology (including dialysis and transplantation), and hypertension. Furthermore, articles addressing healthcare policy and care delivery issues relevant to nephrology are warmly welcomed.