Analysis of the Efficacy and Safety of Exercise in Hemodialysis

Objectives: This project plans to conduct a randomized controlled trial to investigate whether hemodialysis patients can benefit from cycling during dialysis, and whether it can improve dialysis efficiency and safety. Methods:One hundred and twenty-five dialysis patients undergoing regular hemodialysis (dialysis for more than 3 months, three times a week, each session lasting 4 hours, with blood flow set between 250 to 350 ml/min, and dialysate flow at 500 ml/min, with dialysate calcium concentration maintained between 1.25 to 1.5 mmol/L) were randomly assigned into three groups.Group A received intensive treatment, aiming for 70% of Maximal Heart Rate (HRmax), and participated in bed cycling exercise during each dialysis session; Group B received treatment with low-intensity exercise targeting 55% of HRR standards; Group C served as the control group undergoing normal dialysis procedures.Participants in the intervention groups exercised three times a week, with each session lasting between 30 to 60 minutes.The weight and blood pressure of all participants were recorded during each session, and fasting blood samples were collected every 3 months for biochemical analyses, including C-Reactive Protein (CRP), Hemoglobin (HGB), serum Intact Parathyroid Hormone (iPTH), ferritin, and urea nitrogen reduction rate.Additionally, blood pressure, dry weight compliance, KT/V, and hemoglobin status were calculated for all three groups.The incidence of serious infections such as pulmonary, urinary tract, and bloodstream infections, as well as the hospitalization rates, were also documented for each group.Results: Following the intervention, intradialytic hypotension and URR in patients showed significant improvement compared to the control group, with statistically significant differences observed (P<0.05).Additionally, the incidence of complications and hospitalization rates markedly decreased, also exhibiting statistically significant differences (P<0.05).However, there were no statistically significant differences observed in the remaining indicators (P>0.05). Conclusion:Cycling during dialysis can be beneficial for patients undergoing hemodialysis by enhancing its efficiency and stabilizing blood pressure, thus reducing the occurrence of dialysis hypotension.This practice facilitates adequate dialysis, improves physical function, enhances quality of life, and reduces or delays related complications.Furthermore, its occurrence and development carry economic benefits and social value.