Germain M, Beliveau S, Mulhern J, O'Shea M, Braden G
Effect of intradialytic exercise on urea kinetics and rebound
Am Soc Nephrol
J Am Soc Nephrol (abstract) (Nov) 6:599 1995

This study like that of Ronco et al showed, using patients as their own controls, that exercise improved urea removal during hemodialysis. Both urea rebound and potassium rebound were markedly reduced by exercise and the amount of potassium removed was slightly increased. The level of exercise was fairly vigorous and the modest improvement in solute removal could be duplicated by extending the dialysis. Those patients with more severe disequilibrium in the absence of exercise seemed to benefit most from exercise.

Comment: Solute disequilibrium that is blood flow dependent has been predicted to occur mostly in muscle because of the low blood flow/tissue volume ratio in this tissue at rest. During vigorous exercise muscle blood flow has been shown to increase by a factor of 10 to 30. The reduction of rebound by exercise demonstrated by these investigators provides additional support for the dependency of disequilibrium on blood flow and gives the patient another incentive to take advantage of the free time available during hemodialysis for exercise. (Depner)

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Am Soc Nephrol
Basic hemodialysis : Adequacy, prescription, urea kinetics
Basic hemodialysis : Physiology