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J Nephropathol. 2020;9(1): e07.
doi: 10.15171/jnp.2020.07

Scopus ID: 85078300793
  Abstract View: 236
  PDF Download: 91

Original Article

Intradialytic exercise increases cardiac power index 

Brent A. Momb 1 * ORCID logo, Samuel A.E Headley 2 ORCID logo, Tracey D. Matthews 2 ORCID logo, Michael J. Germain 3 ORCID logo

1 Department of Kinesiology, University of Massachusetts, Amherst, MA, USA
2 Department of Exercise Science and Athletic Training, Springfield College, Springfield, MA, USA
3 Department of Nephrology, Renal and Transplant Associates, Springfield, MA, USA

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 .

Keywords: Cardiovascular, Dialysis, Exercise, Kidney, End-stage renal disease, Chronic kidney disease

Implication for health policy/practice/research/medical education:

ESRD patients undergo hypotension and perfusion issues during hemodialysis. Acute aerobic exercise during a hemodialysis session was investigated to determine if CPI would increase compared to a control session. CPI was enhanced through increases in cardiac output and may improve perfusion during hemodialysis.

Please cite this paper as: Momb BA, Headley SAE, Matthews TD, Germain MJ. Intradialytic exercise increases cardiac power index. J Nephropathol. 2020;9(1):e07. DOI: 10.15171/jnp.2020.07.

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Abstract View: 236

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Submitted: 10 Oct 2019
Accepted: 20 Nov 2019
ePublished: 06 Dec 2019
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