“Intra-dialytic cycling”, i.e. cycling during dialysis, would allow patients with renal insufficiency to better fight against the cardiac consequences of this treatment.
- Cycling during dialysis has restored heart size, reduced scarring and arterial stiffness.
- This exercise breaks the inactivity of four hours of dialysis, an operation that is repeated several times a week for most patients.
Two treatments in one. Cardiovascular disease is the leading cause of death in hemodialysis patients. Dialysis sometimes causes heart scarring which, building up over time, can lead to heart failure. Physical exercise is known to help reduce many cardiovascular risk factors. British researchers from the University of Leicester suggest that these patients do double duty by engaging in “intra-dialytic cycling”, that is to say cycling during dialysis. Their findings were published on April 8 in the journal Kidney International.
Reduce the healthcare bill
Researchers developed the “CYCLE-HD” trial, a prospective, open-label, randomized trial that assesses the effect of cycling on heart health during dialysis. They were particularly attentive to the consequences of such a program on the left ventricular mass of the heart among other relevant prognostic measures of cardiovascular disease. For six months, one group of patients did intra-dialytic cycling while another group continued usual care. In practice, participants in the intervention group had to do 30 minutes of moderate-intensity exercise on a specially adapted bicycle during their dialysis sessions. After 6 months, the participants’ hearts were assessed by cardiac MRI and compared to the MRI performed before the start of the trial.
This experiment revealed patients who cycled while on dialysis experienced several improvements in different aspects of heart health: restoring heart size, reduction in the number of scars, and reduction in arterial stiffness. In addition, this has allowed savings in care, precisely linked to heart health, estimated at 1,500 euros per patient. “Being more active reduces the risk of heart disease, helps control weight, lowers blood pressure and cholesterol, and improves mental healthwelcomes James Burton, professor of nephrology at the University of Leicester and lead author of the study. For all these reasons, but especially because the risk of heart disease is so high in these patients, staying active is especially important for people on dialysis.”
Break the inactivity of the four hours of dialysis
The goal, the researchers note, is to break the inactivity of four hours of dialysis, an operation that is repeated several times a week for most patients. With the bike, they hope to offer a way to combine activity and care, reduce the side effects of dialysis and even save money. “Exercise during dialysis can provide a number of benefits. Cycling keeps our patients active and helps them get through those long periods of treatment. This simple intervention keeps their heart healthy and offsets the major heart risk associated with kidney failure”, concluded James Burton.
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