Key Points

Patients undergoing hemodialysis experience a decrease in regional cerebral oxygenation (rSO2) during hemodialysis.This randomized crossover trial investigated acute changes in the rSO2 by intradialytic exercise.This study revealed that acute intradialytic exercise increased the rSO2 and offset the decrease in rSO2 during hemodialysis.

Background

Cognitive dysfunction in hemodialysis patients is associated with a decrease in regional cerebral oxygenation (rSO2). Intradialytic exercise improves cognitive function; nonetheless, the acute effect of intradialytic exercise on cerebral circulation remains unknown. This study aimed to evaluate the acute effect of intradialytic exercise on rSO2 during hemodialysis.

Methods

This single-center, open-label, randomized crossover trial included 20 hemodialysis patients. Patients received the control condition as usual care and the intradialytic exercise condition in random order. The intradialytic exercise condition involved the performance of anaerobic threshold–intensity interval exercise for 35 minutes. Cerebral oxygenation (rSO2, oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin) in the prefrontal cortex was measured using near-infrared spectroscopy during hemodialysis. Cardiovascular responses, including the heart rate, cardiac index, mean arterial pressure, and blood gas, were also assessed. The two conditions were compared using two-way repeated-measures analysis of variance.

Results

The analysis included 16 patients, four of whom were excluded because of artifacts in the cerebral oxygenation data. The rSO2 (P

Conclusions

Intradialytic exercise significantly increased rSO2 during and after exercise and improved rSO2 to the same extent as predialysis.

Clinical Trial registry name and registration number:

University Hospital Medical Information Network Center Clinical Trials Registry. Registry name: Effect of Intradialytic Aerobic Exercise to Changes in Regional Oxygen Saturation during Hemodialysis. Registration: UMIN000048885.