A randomised, cluster controlled trial to investigate the effects of a programme of intradialytic exercise on cardiovascular outcomes in haemodialysis patients.
Topic: Renal disorders; Subtopic: Renal disorders; Disease: All Renal disorders
The study will compare six month of cycling exercise during dialysis (intervention group) against normal dialysis care (no intervention). The intervention group will use specially adapted and calibrated exercise bicycles three times a week during dialysis, aiming for 30 minutes continuous cycling at a level perceived by patients as 'somewhat hard'. This is set on an individual basis after an assessment with a trained member of staff and is then adjusted as required to progress training. Our pilot exercise programme has been well tolerated with no adverse symptoms reported in any of the exercising patients. It is accessible to patients of different age, gender, culture and ethnicity.
1. Be a prevalent haemodialysis patient (on haemodialysis for more than 3 months) 2. Age 18 years or older 3. Able and willing to give informed consent
1. Unable to participate in current exercise program due to perceived physical or psychological barriers 2. Unable to undergo MRI scanning (metal implants / prostheses, claustrophobia etc.) 3. Unfit to undertake exercise according to the American College of Sports Medicine guidelines 4. Contraindications to exercise testing (35) that include: 4.1. Recent significant change in resting ECG that suggests significant ischaemia, recent myocardial infarction (2 weeks) or other acute cardiac event; 4.2. Unstable angina; 4.3. Uncontrolled cardiac dysrhythmias causing symptoms or haemodynamic compromise; 4.4. Symptomatic severe aortic stenosis 4.5. Uncontrolled symptomatic heart failure 4.6. Acute pulmonary embolus or pulmonary infarction 4.7. Acute myocarditis or pericarditis 4.8. Suspected or known dissecting aneurysm 4.9. Acute systemic infection, accompanied by fever, body aches or swollen lymph glands 5. Age <18 years 6. Unable or unwilling to give informed consent