Enhancing Dialysis Adequacy: Effects of Intradialytic Exercise

NCT ID: NCT01481688

Last Updated: 2011-11-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

14 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-11-30

Study Completion Date

2012-01-31

Brief Summary

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The purpose of this study is to investigate whether intradialytic exercise increases removal of waste products from blood, in comparison to the traditional prescription of increasing dialysis duration.

Detailed Description

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For patients with severe chronic kidney disease, regular dialysis to remove toxins and waste products from the blood is essential to maintain life. The adequacy of dialysis is quantified by the removal of these toxic solutes and is an important parameter in the assessment of the therapy.

Previous efforts to enhance urea clearance have centered around factors such as increasing dialysis dose by increasing dialysis time or carrying out more frequent dialysis sessions. However this concept is confronted with the barriers of patient compliance and cost implications. Many patients are resilient to increasing their dialysis time, presenting a major challenge for enhancing the efficacy of dialysis therapy. Therefore, alternative methods of improving dialysis adequacy, with interventions aimed at enhancing solute clearance, are highly warranted.

One such intervention could be exercising during haemodialysis (HD). 85% of the body is comprised of lean tissue, of which 73% is water. As many toxic solutes are water based, large amounts will be stored in the muscle. When sitting at rest during HD the blood flow to the muscles is four times less compared to the major organs. Additionally, the HD process causes blood vessels to constrict, further restricting blood flow to the muscle. Consequently there is insufficient blood flow to remove the toxins stored in the muscle. By exercising during dialysis, blood flow to the muscle is increased to sustain the demand for oxygen and energy, thereby allowing toxic solutes to be removed and cleared through the dialysis machine.

Therefore the aim of this study is to implement an efficient exercise intervention during dialysis and determine its effects on dialysis adequacy in comparison to the traditional prescription of increased dialysis time. In particular, the study aims to explore the acute effects of exercise during dialysis on the removal of several established uremic toxins.

Conditions

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Chronic Kidney Disease

Keywords

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Dialysis adequacy Urea clearance Phosphate clearance Beta 2 microglobulin clearance Intradialytic exercise Haemodialysis patients

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Control

Routine haemodialysis sessions as per usual

Group Type NO_INTERVENTION

No interventions assigned to this group

Intradialytic exercise

One hour of exercise completed during haemodialysis.

Group Type EXPERIMENTAL

Exercise

Intervention Type OTHER

Exercise During Dialysis Patients will be asked to carry out cycling exercise for 60 minutes during the third quarter of their routine haemodialysis session. Exercise can be carried out in ten minute bouts with several minutes rest between bouts.

Extra time

30 minutes extra dialysis time.

Group Type ACTIVE_COMPARATOR

Extra time

Intervention Type OTHER

An extra 30 minutes will be added to the currently prescribed treatment time of each patient.

Interventions

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Exercise

Exercise During Dialysis Patients will be asked to carry out cycling exercise for 60 minutes during the third quarter of their routine haemodialysis session. Exercise can be carried out in ten minute bouts with several minutes rest between bouts.

Intervention Type OTHER

Extra time

An extra 30 minutes will be added to the currently prescribed treatment time of each patient.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Stage 5 Chronic Kidney Disease
* Receiving maintenance haemodialysis for \> 3 months

Exclusion Criteria

* Unable to give consent
* Present with contraindications to take part in exercise
* Haemoglobin \<11 g/dL
* Access recirculation
* Chronic persistent hypotension with pre dialysis systolic blood pressures \<100mgHg.
* Episodic treatment induced hypotension with frequent drops in intradialytic systolic blood pressure \>30mmgHg
* Unstable medical condition
* Currently taking medication affecting urea or creatinine generation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Betsi Cadwaladr University Health Board

OTHER_GOV

Sponsor Role collaborator

B.Braun Avitum AG

INDUSTRY

Sponsor Role collaborator

Bangor University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jamie H Macdonald, PhD

Role: STUDY_DIRECTOR

Bangor University

Locations

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Renal unit, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board

Bangor, Gwynedd, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Jamie H Macdonald, PhD

Role: CONTACT

Phone: 0044 1248 383272

Email: [email protected]

References

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Bernier-Jean A, Beruni NA, Bondonno NP, Williams G, Teixeira-Pinto A, Craig JC, Wong G. Exercise training for adults undergoing maintenance dialysis. Cochrane Database Syst Rev. 2022 Jan 12;1(1):CD014653. doi: 10.1002/14651858.CD014653.

Reference Type DERIVED
PMID: 35018639 (View on PubMed)

Other Identifiers

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Kirkman 11/WA/0112

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

11/WA/0112

Identifier Type: -

Identifier Source: org_study_id