Acute Effect of Intradialytic Aerobic Exercise on Hemodynamic Response, Dialysis-Related Side Effects and Proteome in Patients with Kidney Failure: A Pilot Study

Background/Objectives: Hemodialysis (HD) is the renal replacement therapy with the most adverse side effects, including variations in blood pressure (BP). Intradialytic exercise (IDE) seems to be the non-pharmacological approach of choice for managing treatment-induced symptoms. The objectives were (1) to evaluate the effect of acute IDE on hemodynamic response (BP) and short-term treatment-associated symptoms in patients with kidney failure and (2) to test the feasibility to quantify the proteome of these patients in response to IDE and establish its relationship with BP variations during HD. Methods: Ten adults undergoing HD completed a randomized crossover study with two experimental conditions (HD; HD with IDE). BP was measured before and after HD, and at five time points following conditions. Symptom burden was assessed 24 h and 7 days after each condition. Blood samples were collected for proteomics analysis at the end of conditions. Results: IDE downregulated BP during HD without adverse events and decreased the desire to sleep in the 2 hours following HD. Proteomics analysis revealed that five proteins were downregulated and seven upregulated in response to IDE, although it was not associated with BP variation. Conclusion and Implications: A single session of moderate-intensity IDE seems sufficient to improve BP control and to reduce the desire to sleep after treatment without any adverse effects. This study also demonstrates that it is feasible to quantify the proteome in individuals with kidney failure, which could lead to the development of precision interventions in exercise to improve the quality of care for deconditioned, multimorbid individuals.