title: The Impact of Exercising During Haemodialysis on Blood Pressure, Markers of Cardiac Injury and Systemic Inflammation--Preliminary Results of a Pilot Study.
abstract: OBJECTIVE
  Patients requiring haemodialysis have cardiovascular and immune dysfunction. Little is known about the acute effects of exercise during haemodialysis. Exercise has numerous health benefits but in other populations has a profound impact upon blood pressure, inflammation and immune function; therefore having the potential to exacerbate cardiovascular and immune dysfunction in this vulnerable population.
  
  
  METHODS
  Fifteen patients took part in a randomised-crossover study investigating the effect of a 30-min bout of exercise during haemodialysis compared to resting haemodialysis. We assessed blood pressure, plasma markers of cardiac injury and systemic inflammation and neutrophil degranulation.
  
  
  RESULTS
  Exercise increased blood pressure immediately post-exercise; however, 1 hour after exercise blood pressure was lower than resting levels (106±22 vs. 117±25 mm Hg). No differences in h-FABP, cTnI, myoglobin or CKMB were observed between trial arms. Exercise did not alter circulating concentrations of IL-6, TNF-α or IL-1ra nor clearly suppress neutrophil function.
  
  
  CONCLUSIONS
  This study demonstrates fluctuations in blood pressure during haemodialysis in response to exercise. However, since the fall in blood pressure occurred without evidence of cardiac injury, we regard it as a normal response to exercise superimposed onto the haemodynamic response to haemodialysis. Importantly, exercise did not exacerbate systemic inflammation or immune dysfunction; intradialytic exercise was well tolerated.
authors.affiliation: Leicester Kidney Exercise Team, John Walls Renal Unit, University Hospitals of Leicester, Leicestershire, United Kingdom.
authors.forename: Maurice
authors.initials: M
authors.lastname: Dungey
authors.forename: Nicolette C
authors.initials: NC
authors.lastname: Bishop
authors.forename: Hannah M L
authors.initials: HM
authors.lastname: Young
authors.forename: James O
authors.initials: JO
authors.lastname: Burton
authors.forename: Alice C
authors.initials: AC
authors.lastname: Smith
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology*; D015550:Cell Degranulation; D018592:Cross-Over Studies; D016207:Cytokines / Q000097:blood; D015444:Exercise / Q000502:physiology*; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D010865:Pilot Projects; D006435:Renal Dialysis
chemical_list: D015415:Biomarkers; D016207:Cytokines