Document Detail


Improvement in exercise duration and capacity after conversion to nocturnal home haemodialysis.
MedLine Citation:
PMID:  17595181     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with end-stage renal disease (ESRD) have a reduced exercise capacity as assessed by peak oxygen uptake (VO2peak). Nocturnal haemodialysis (NHD) augments uraemic clearance and vascular responsiveness to nitric oxide and lowers blood pressure (BP) and peripheral resistance. METHODS: To assess the impact of NHD on exercise duration and capacity, 13 consecutive ESRD patients [age: 41 +/- 3; (mean +/- SEM)] and healthy normal subjects (n = 14) matched for age and body mass index exercised to peak effort (VO2peak) as determined by open-circuit spirometry during a graded cycle ergometer test with a ramp increase in work rate (by 17 watts/min). RESULTS: Exercise was performed before, 2 and 3-6 months after conversion from conventional haemodialysis (CHD) (3 sessions per week; 4 h per session) to NHD (5-6 sessions per week; 6-8 h per session). Exercise duration increased progressively [from 617 +/- 50 (CHD) to 634 +/- 47 (NHD 2 months) to 682 +/- 55 [NHD 3-6 months], P = 0.03) as did exercise capacity, expressed as percent of predicted (based on age, sex and body size) VO2peak, [from 66 +/- 8 (CHD) to 72 +/- 6 (NHD 2 months) to 75 +/- 6% (NHD 3-6 months), P < 0.05). CONCLUSION: Enhanced uraemia control by NHD improved both exercise duration and capacity. When coupled with augmented uraemia management, an increase in physical activity, perhaps due to more effective oxygen delivery or improved muscle metabolism, has the potential to improve the quality of life of patients with ESRD.
Authors:
Christopher T Chan; Catherine F Notarius; Anthony C Merlocco; John S Floras
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-06-25
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  22     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-30     Completed Date:  2008-03-10     Revised Date:  2009-02-20    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  3285-91     Citation Subset:  IM    
Affiliation:
Department of Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Ontario, Canada. christopher.chan@uhn.on.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Diabetic Nephropathies / physiopathology,  therapy
Energy Metabolism
Exercise / physiology*
Female
Health Status
Hemodialysis, Home*
Humans
Kidney Diseases / complications
Kidney Failure, Chronic / physiopathology*,  therapy*
Male
Muscle, Skeletal / physiopathology
Oxygen Consumption
Spirometry
Comments/Corrections
Comment In:
Nephrol Dial Transplant. 2008 Aug;23(8):2703-4; author reply 2704   [PMID:  18463326 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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