The Impact of Exercising During Haemodialysis on Blood Pressure, Markers of Cardiac Injury and Systemic Inflammation - Preliminary Results of a Pilot Study

Background/Aims: Patients requiring haemodialysis have cardiovascular and immune dysfunction. Little is known about the acute effects of exercise during haemodialysis. Exercise has numerous health benefits but in other populations has a profound impact upon blood pressure, inflammation and immune fu...

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Bibliographic Details
Published in:Kidney & blood pressure research 2015-01, Vol.40 (6), p.593-604
Main Authors: Dungey, Maurice, Bishop, Nicolette C., Young, Hannah M.L., Burton, James O., Smith, Alice C.
Format: Article
Language:English
Subjects:
Aged
Biomarkers - blood
Blood pressure
Blood Pressure - physiology
Cardiovascular disease
Cell Degranulation
Cross-Over Studies
Cytokines - blood
Exercise
Exercise - physiology
Female
Haemodialysis
Heart Diseases - physiopathology
Hemodynamics
Humans
Inflammation
Inflammation - physiopathology
Male
Middle Aged
Neutrophils - pathology
Original Paper
Pilot Projects
Renal Dialysis
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Summary:Background/Aims: Patients requiring haemodialysis have cardiovascular and immune dysfunction. Little is known about the acute effects of exercise during haemodialysis. Exercise has numerous health benefits but in other populations has a profound impact upon blood pressure, inflammation and immune function; therefore having the potential to exacerbate cardiovascular and immune dysfunction in this vulnerable population. Methods: Fifteen patients took part in a randomised-crossover study investigating the effect of a 30-min bout of exercise during haemodialysis compared to resting haemodialysis. We assessed blood pressure, plasma markers of cardiac injury and systemic inflammation and neutrophil degranulation. Results: Exercise increased blood pressure immediately post-exercise; however, 1 hour after exercise blood pressure was lower than resting levels (106±22 vs. 117±25 mm Hg). No differences in h-FABP, cTnI, myoglobin or CKMB were observed between trial arms. Exercise did not alter circulating concentrations of IL-6, TNF-α or IL-1ra nor clearly suppress neutrophil function. Conclusions: This study demonstrates fluctuations in blood pressure during haemodialysis in response to exercise. However, since the fall in blood pressure occurred without evidence of cardiac injury, we regard it as a normal response to exercise superimposed onto the haemodynamic response to haemodialysis. Importantly, exercise did not exacerbate systemic inflammation or immune dysfunction; intradialytic exercise was well tolerated.
ISSN:1420-4096
1423-0143
DOI:10.1159/000368535