Chronic Kidney Disease Stage 5 Clinical Trial
Official title:
The Effect of an Intra-dialytic Aerobic Exercise Intervention on Vascular Function in People Undergoing Maintenance Haemodialysis Therapy for Chronic Kidney Disease Stage 5. An Exploratory Study
The aim of this study is to evaluate whether a three month intra-dialytic exercise programme improves arterial function.
Life expectancies in haemodialysis patients are significantly shorter than the general
population due to higher cardiovascular disease risk. This is mediated by higher prevalence
of cardiovascular risk factors associated with chronic kidney disease and the haemodialysis
procedure. Consequently ageing of the arterial system is accelerated in this condition
leading to higher prevalence of arterial plaques and increased arterial stiffness.
Higher physical activity and fitness are associated with lower cardiovascular disease and
all-cause mortality in haemodialysis patients and the general population. Moreover, physical
inactivity is associated with increased arterial stiffness and plaques which narrow heart
arteries. Worryingly the haemodialysis population is on average highly inactive with low
fitness.
Current research demonstrates that exercise which improves fitness improves arterial health.
Increased bloodflow during exercise stimulates the release of nitric oxide causing arteries
to dilate. Regular exercise is believed to lead to beneficial remodelling of arteries and
lower arterial stiffness. Exercise is reported to improve arterial function across a range
of conditions. However published research regarding the possible benefits of long term
aerobic exercise on arterial health in this population is conflicting. Limitations in study
design, moderately high participant dropout rates and low statistical power hamper a
definitive conclusion. Importantly a gold standard measure of arterial function has not been
used in previously published studies.
There is ample evidence that exercise programmes in people on dialysis improve fitness,
physical function, and quality of life. It is also clear that a state of higher physical
activity and fitness is associated with better arterial function in the general population.
It would be advantageous for reasons of health counselling to determine whether the process
of improving physical fitness and activity levels may also improve arterial health in
haemodialysis patients.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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