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Eur J Prev Cardiol. 2015 Jul;22(7):912-9. doi: 10.1177/2047487314543079. Epub 2014 Jul 18.

Intra-dialytic training accelerates oxygen uptake kinetics in hemodialysis patients.

Author information

1
Division of Pulmonology, Federal University of Juiz de Fora, Brazil NIEPEN, Federal University of Juiz de Fora, Brazil mayconreboredo@yahoo.com.br.
2
Division of Respiratory and Critical Care Medicine, Queen's University, Canada.
3
Division of Pulmonology, Federal University of Juiz de Fora, Brazil.
4
NIEPEN, Federal University of Juiz de Fora, Brazil.

Abstract

BACKGROUND:

End-stage renal disease is associated with several hemodynamic and peripheral muscle abnormalities that could slow the rate of change in oxygen uptake ([Formula: see text]O2) at the onset and at the end of exercise. This study was performed to determine whether an intra-dialytic aerobic training program would speed [Formula: see text]O2 kinetics at the transition to and from moderate and high-intensity exercise.

DESIGN:

This study was a randomized controlled trial.

METHODS:

Twenty-four patients with end-stage renal disease (14 females; 47.0 ± 11.9 years) were randomly assigned to either 12-week cycle ergometer-based training at moderate exertion or a similar control period. At initial and final evaluations, patients underwent 6 min moderate and high-intensity tests to exercise intolerance (Tlim).

RESULTS:

Training improved Tlim by ∼90% (median (inter-quartile range) = 232 (59) s to 445 (451) s, p < 0.05); in contrast, Tlim decreased by ∼30% in controls (291 (134) s to 202 (131) s). [Formula: see text]O2 kinetics at the onset of moderate-intensity exercise were significantly accelerated with training leading to lower oxygen (O2) deficit (mean ± standard deviation (SD) = 3.2 ± 1.3 l vs 2.3 ± 1.2 l). Similar positive effects were found at the high-intensity test either at the onset of, or recovery from, exercise (p < 0.05). "Excess" [Formula: see text]O2 at the high-intensity test was also lessened with training. Changes in Tlim correlated with faster [Formula: see text]O2 kinetics and lower "excess" [Formula: see text]O2 (Spearman's ρ = -0.56 and -0.75, respectively; p < 0.01).

CONCLUSIONS:

A symptom-targeted intra-dialytic training program improved sub-maximal aerobic metabolism and endurance exercise capacity. [Formula: see text]O2 kinetics are valuable in providing relatively effort-independent information on the efficacy of exercise interventions in this patient population.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01234688.

KEYWORDS:

Aerobic exercise; end-stage renal disease; exercise tolerance; hemodialysis; oxygen uptake kinetics

PMID:
25038079
DOI:
10.1177/2047487314543079
[Indexed for MEDLINE]
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