Patients with chronic kidney disease (CKD) usually presents exercise intolerance, vascular and cerebral impairment leading to cognitive dysfunction. Changes in cerebral hemodynamics maybe involved in pathogenesis of CKD in hemodialysis (HD) patients. The hypothesis of this randomized, physiotherapy controlled study has to evaluate if in the intradialytic aerobic exercise (IDAE) has any effect on endothelial function (EF), cerebral blood flow and cognitive function in such patients.Design and Method:
So, all were in HD, 3x/w, selected after a treadmill test by Bruce protocol to exclude coronary artery disease and to calculate VO2max and aerobic capacity. 30 patients were randomized to exercise group or control and recorded: central blood pressure and arterial stiffness by Sphygmocor device; flow mediated dilatation (%) in radial artery by ultrasound to access EF; transcranial doppler sonography in 9 cerebral arteries to measure blood flow, mini-mental state examination (MMSE) to evaluate cognitive function and laboratory tests to establish CKD and inflammation. 15 patients in the exercise group performed IDAE three times a week for 4 months and control group had no intervention. All parameters were measured again at the end of 4 months, during no HD days and all the evaluators were masked from the participants. Two ways variance analysis for repetitive data,* Poison regression and Student “t” test** was applied. Results were presented as Mean ± SD.Results:
For the first time we found that an aerobic exercise program applied to CKD-HD patients’ had a beneficial effect increasing cerebral flow and improving EF and cognitive function where reducing inflammation degree may play a role.