Objective To investigate the effects of exercise rehabilitation on dialysis adequacy, nutrition, and lipid metabolism in maintenance hemodialysis (MHD) patients. Methods A total of 87 patients with inadequate dialysis from the Blood Purification Center of Nantong Second People's Hospital were selected. They were randomly divided into two groups: a control group receiving conventional treatment (including medication and hemodialysis) and an exercise group receiving conventional treatment plus aerobic and resistance exercises. The urea clearance index (Kt/V), nutritional markers, and lipid metabolism markers were compared between the two groups before the intervention, at 12 weeks (12W), and at 24 weeks (24W). Results After 12 weeks and 24 weeks of intervention, the exercise group showed significantly higher Kt/V (t =-4.282, -6.535; both P <0.001) and serum albumin (Alb) levels (t =-3.603, -5.333; P = 0.001, <0.001) compared to the control group. While the exercise group had significantly lower total cholesterol (TC) (t = 4.035, 3.918; both P< 0.001) and low-density lipoprotein (LDL) levels (t =2.258, 4.483; P =0.027, <0.001) than the control group. At 24 weeks of intervention, C-reactive protein (CRP) in the exercise group was significantly lower than that in the control group (intergroup Z=-4.349, P<0.001). Compared to pre-intervention levels, the exercise group demonstrated significantly increased high-density lipoprotein (HDL) levels at both 12W and 24W (t =-2.425, -2.085; P=0.020, 0.043). Conclusion Aerobic and resistance exercise significantly improves dialysis adequacy, nutritional status, and lipid metabolism in MHD patients.
DING Fen-Fen
,
JIANG Xia
. The effects of exercise rehabilitation on dialysis adequacy, nutrition and lipid metabolism in maintenance hemodialysis patients[J]. Chinese Journal of Blood Purification, 2025
, 24(07)
: 581
-585
.
DOI: 10.3969/j.issn.1671-4091.2025.07.008
[1] 高艳,房艳辉,郜同心,等.血液透析充分性的影响因素分析[J].临床肾脏病杂志,2020,20(7):567-572.
[2] 宋亦琪,倪丽,陈靖.维持性血液透析患者营养评估及相关进展.中国血液净化, 2018, 17(1): 51-53.
[3] Wu YH, Hsu YJ, Tzeng WC. Physical activity and health-related quality of life of patients on
hemodialysis with comorbidities: a cross-sectional study. International Journal of
Environmental Research and Public Health. 2022;19(2):811.
[4] 王晓菁,张昆,葛颜,等.血液透析中运动对维持性血液透析患者炎症氧化应激及内皮功能
的影响[J].中国血液净化, 2019, 18(06): 390-393.
[5] Li X, Shan Y, Jiang T, et al. Research progress on resistance exercise applied in nursing care
of patients with maintenance hemodialysis complicated with sarcopenia. Journal of Nursing
Research. 2021;35(04):643–647.
[6] 中国医师协会康复医师分会肾康复专业委员会,马迎春.我国成人慢性肾脏病患者运动康复的专家共识[J].中华肾脏病杂志,2019; 35(7):537-43.
[7] 尹丽霞,胡晓艳,张海林,等.透析中运动对维持性血液透析患者透析充分性及睡眠质量的影响[J].中国护理管理, 2017, 17(11): 1478-1481.
[8] 王颖,甘良英,梁俊卿,等.维持性血液透析患者透析中运动康复退出率的多中心调查.中国血液净化, 2018, 17(12): 810-813.
[9] Wei S. Effect of resistance exercise intervention on dialysis adequacy in maintenance hemodialysis patients. Nursing Practice and Research. 2018;15(10):31–32.
[10] Luo X, Deng S, Chen J, et al. The effect of 9 types of exercise in improving the dialysis adequacy on patients undergoing hemodialysis: a network meta-analysis. Chinese Journal of Nursing. 2022;57(23):2921–2929.
[11] 张元丽,刘英莲,林子程,等.中医传统运动理论指导下运动管理对MHD患者透析充分性和微炎症状态的影响[J].中国老年学杂志,2022,42(17):4210-4214.
[12] Ferro CJ, Mark PB, Kanbay M, et al. Lipid management in patients with chronic kidney disease. Nat Rev Nephrol. 2018;14:727–749.
[13] Frih B, Jaafar H, Mkacher W, et al. The effect of Interdialytic combined resistance and aerobic exercise training on health related outcomes in chronic hemodialysis patients: the Tunisian randomized controlled study. Front Physiol. 2017;8:288.
[14] Keller U. Nutritional Laboratory Markers in Malnutrition. J. Clin. Med. 2019;8.
[15] Levitt DG, Levitt MD. Human serum albumin homeostasis: A new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. Int. J. Gen. Med. 2016;9:229–255.
[16] Hanafusa N, Nitta K, Okazaki M, et al. Serum albumin level adjusted with C-reactive protein predicts hemodialysis patient survival. Ren. Replace. Ther. 2017;3:9.
[17] Cheng YJ, Zhao XJ, Zeng W, et al. Effect of Intradialytic Exercise on Physical Performance and Cardiovascular Risk Factors in Patients Receiving Maintenance Hemodialysis: A Pilot and Feasibility Study. Blood Purif. 2019.
[18] Frih B, Jaafar H, Mkacher W, et al. The Effect of Interdialytic Combined Resistance and Aerobic Exercise Training on Health Related Outcomes in Chronic Hemodialysis Patients: The Tunisian Randomized Controlled Study. Front. Physiol. 2017;8:288.
[19] Chan D, Cheema BS. Progressive Resistance Training in End-Stage Renal Disease: Systematic Review. Am. J. Nephrol. 2016;44:32–45.
[20] Zhang F, Zhou W, Sun Q, et al. Effects of intradialytic resistance exercises on physical performance, nutrient intake and quality of life among haemodialysis people: A systematic review and meta-analysis. Nurs. Open. 2019.