Introduction: Chronic kidney disease (CKD) requires life-sustaining therapies such as hemodialysis (HD), which negatively affects patients' quality of life. Physical exercise has emerged as a promising, non-pharmacological strategy to mitigate these adverse effects. Methods: This clinical study, conducted in Guarapuava, Brazil, included 41 HD patients who were divided into an intervention group (IG, n=28n=28 ) and a control group (CG, n=13n=13 ). Assessments were performed at baseline and after an eight- week intrarenalytic physical exercise program. The intervention consisted of stretching, resistance training (quadriceps, hip abductors/adductors, and ankle musculature), and aerobic activity (using a cycle ergometer). Exercises were individualized and monitored by measuring vital signs and applying the Borg Rating of Perceived Exertion Scale. Results: Forty- one participants (28 IG, 13 CG) completed the protocol. The mean age was 56.5±10.2256.5±10.22 years, with hypertension and diabetes mellitus (DM) as the most prevalent comorbidities. Participants with DM had higher body mass index (BMI) and significantly lower dialysis adequacy (Kt/V). After intervention, the IG showed significant improvements in dialysis adequacy (from 1.27 to 1.42; p=0.004p=0.004 ), handgrip strength ( p=0.001p=0.001 ), and Barthel Index scores ( p=0.0021p=0.0021 ), reflecting greater independence in activities of daily living. Multivariate analysis (MANOVA) and Hedges' gg indicated moderate to large effect sizes, supporting the clinical relevance of these gains. Conclusion: The findings indicate that intrarenalytic physical exercise yields clinically meaningful functional and physiological improvements, reinforcing its relevance as an effective adjunct to routine care for CKD patients undergoing hemodialysis.
Júnior et al. (Tue,) studied this question.