The Effectiveness of Physical Activity During Hemodialysis on Dialysis Adequacy in Hemodialysis Patients: A Clinical Trial Study

Abstract Background In patients with chronic renal failure undergoing hemodialysis, activity, and rehabilitation are very important to prevent the reduction of muscle strength and performance of the patient undergoing dialysis. This study aims to determine the effectiveness of physical activity during hemodialysis on dialysis adequacy in hemodialysis patients. Methods This randomized controlled trial study investigated the impact of pedaling exercise on dialysis effectiveness in 84 hemodialysis patients at Bushehr hospitals. Participants were randomly assigned to either an experimental group (n = 42) that performed 30 minutes of pedaling exercise during their 4-hour dialysis sessions or a control group (n = 42) that received routine hemodialysis. Dialysis adequacy was assessed by comparing pre-and post-dialysis blood samples taken from the arterial line. The study utilized a standardized protocol for collecting blood samples and measured patient weight using a calibrated digital scale. Data analysis was performed using SPSS.ver24 software. Results The test and control groups were similar in demographic characteristics, except for age (X2= -3/84, p = 0.001) and education levels (X2 = 10/100, p = 0.006). While there was no significant difference in weight before and after the intervention between the groups (t = 0.223, p = 0.82 before; t = 0.203, p = 0.84 after), both groups showed a substantial weight reduction overall (p < 0.0001). There was no statistically significant difference in weight change (t = 0.80, p = 0.25), blood urea nitrogen (BUN) (t = 0.13, p = 1.52), or Kt/V (t = 1.62, p = 0.11) between the test and control groups. Conclusion This study found that incorporating pedaling exercise during hemodialysis did not significantly improve dialysis effectiveness, as measured by weight change, BUN levels, or Kt/V. While both groups showed weight loss, there were no statistically significant differences between them. However, the study had limitations due to its small sample size and the specific type of exercise used. Further research with larger cohorts and a wider variety of physical activities is needed to determine if physical activity during hemodialysis can benefit dialysis adequacy and overall patient outcomes. Trial registration: IRCT code number 20150529022466N15 with registration date: 5.5.2020 and trial Code of Ethics IR.BPUMS.REC.1398.130