Abstract
Introduction: Mortality rates are high in end-stage renal disease due to cardiovascular complications.
Perfusion of the myocardium declines during and after hemodialysis sessions with the potential for
aerobic exercise to mitigate these during hemodialysis.
Objectives: The purpose of this study was to investigate acute changes in hemodynamics in subjects
with end-stage renal disease (ESRD) during exercise.
Patients and Methods: Subjects (n = 10) were monitored for 1.5 hours during hemodialysis treatment
during a control (CON) and an exercise (EX) session. Subjects cycled using an ergometer strapped
to the reclining dialysis chair at an RPE of 11-13 for 30 minutes during the EX session beginning at
30 min into dialysis and ending at 60 minutes. Data for systolic blood pressure (SBP), diastolic blood
pressure (DBP), and mean arterial pressure (MAP) were collected using an automated blood pressure
cuff attached to the hemodialysis machine. Data for cardiac output (Q̇ ), cardiac power index (CPI),
stroke volume (SV), systemic vascular resistance (SVR), and heart rate (HR) were collected using the
NICaS bioelectrical impedance device.
Results: During the EX session, CPI, Q̇ , SV, and HR were significantly greater (P<0.05) than the
CON session. Additionally, Q̇ was significantly (P< 0.05) greater at 45 minutes and 60 minutes
compared to 15 minutes. HR was significantly (P<0.05) greater at 45 minutes compared to 90
minutes. No significant interactions were found for MAP, CPI, Q̇ , HR, SV, SBP, DBP, or SVR.
Conclusion: In conclusion, exercise during dialysis may decrease the likelihood of experiencing
ischemic or hypotensive events by enhancing myocardial perfusion through increasing CPI and Q̇ .