The Effect of Exercise Rehabilitation Regimes in Combination With Changes in Dialysis Procedures in Aspects Related to Quality of Life and Health in End Stage Renal Disease Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 72
- 试验地点
- 5
- 主要终点
- Change in Body Heat Storage
研究概览
简要总结
Despite the tremendous advances in dialysis technology, hemodialysis (HD) is a significant challenge for dialysis patients and quality of their lives[2]. Research has shown for years that dialysate fluid temperature and especially the typical dialysis (TD) temperature at (37°C) are complicated by hemodynamic instability which leading to an increased risk of heat-induced hypotension causing patient discomfort and increased mortality.
Cold dialysis (CD) is defined as the reduction of dialysis fluid temperature to 35-36°C, approximately 1°C below the typical dialysate temperature which ranges between 37-38°C. A number of studies have reported beneficial effects of CD on maintaining hemodynamic stability, minimizes hypotension and exerts a protective effect over major organs including the heart and brain. In addition, current evidence showed the protective effect of CD in cardiac performance during the dialysis session. As the investigators know until today cardiovascular mortality is an important issue for nephrologists that care for ESRD patients, however, many other benefits have been observed on patients' overall health and quality of life levels by used of CD.
The above-mentioned benefits of CD in the hemodynamic stability and the general quality of life of the patients are highlighted even further due to the ever-increasing adoption of intradialytic exercise programs. It has been well established that intradialytic exercise leads to benefits of physiological, functional, and psychological deterioration, which commonly accrues as a consequence of biological aging, catabolic illness, and a sedentary lifestyle, factors that may all contribute to the progressive decline of vitality and quality of life commonly observed in ESRD patients.
However, despite a strong rationale for the implementation of intradialytic exercise programs and the aforementioned benefits of CD, the separate and combined effects of these protocols in aspects related to quality of life and health in ESRD patients have not been investigated to date.
The aim of the current clinical study was to assess the effect of exercise rehabilitation regimes in combination with changes in dialysate temperature in aspects related to quality of life and health in end-stage renal disease patients receiving hemodialysis.
详细描述
The primary aim of the clinical study was to investigate the combined effect of cold dialysis and aerobic exercise in aspects related to health. More specific:
- To investigate the thermoregulatory responses of hemodialysis patients under four different hemodialysis protocols.
- To assess the changes in muscular architecture and functional capacity in dialysis patients after 7 months of intradialytic exercise training.
- To assess the impact on insulin sensitivity and glucose disposal.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinically stable ESRD patients receiving regular hemodialysis treatment for at least 3 months,
- •adequate dialysis delivery Kt/V >1.1
- •good compliance of dialysis treatment
- •serum albumin >2.5 g/dL
- •hemoglobin ≥11g/dL.
排除标准
- •Patients with a reason to be in a catabolic state,
- •hyperthyroidism,
- •active vasculitis,
- •malignancies,
- •pregnancy
- •opportunistic infections,
- •musculoskeletal contraindication to exercise,
- •requirement for systemic anticoagulation,
- •participant or participated in an investigational drug or medical device study within 30 days,
- •active inflammations, that required intravenous antibiotics within 3 months prior to enrollment,
- •diabetics receiving insulin therapy,
- •New York Heart Association grade IV heart failure,
- •mental incapacity to consent.
结局指标
主要结局
Change in Body Heat Storage
时间窗: Changes from baseline at 7 months
Body Heat storage will be assessed during the 4 hours of dialysis under the two main conditions. Body Heat Storage is calculated in Watt
Change in Insulin Resistance
时间窗: Changes from baseline at 7 months
Insulin resistances will be assessed by an Oral Glucose Tolerance Test using the OGIS index
Change in Muscle Size
时间窗: Changes from baseline at 7 months
Muscle size will be assessed using Ultrasonography
次要结局
- Change in Quality of life score(Changes from baseline at 7 months)
- Change in Functional Capacity(Changes from baseline at 7 months)
- Change in Daily Physical activity(Changes from baseline at 7 months)
研究者
Giorgos K. Sakkas
Professor in Clinical Exercise Physiology
University of Thessaly