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