title: Exercise in Patients on Dialysis: A Multicenter, Randomized Clinical Trial.
abstract: Previous studies have suggested the benefits of physical exercise for patients on dialysis. We conducted the Exercise Introduction to Enhance Performance in Dialysis trial, a 6-month randomized, multicenter trial to test whether a simple, personalized walking exercise program at home, managed by dialysis staff, improves functional status in adult patients on dialysis. The main study outcomes included change in physical performance at 6 months, assessed by the 6-minute walking test and the five times sit-to-stand test, and in quality of life, assessed by the Kidney Disease Quality of Life Short Form (KDQOL-SF) questionnaire. We randomized 296 patients to normal physical activity (control;n=145) or walking exercise (n=151); 227 patients (exercisen=104; controln=123) repeated the 6-month evaluations. The distance covered during the 6-minute walking test improved in the exercise group (mean distance±SD: baseline, 328±96 m; 6 months, 367±113 m) but not in the control group (baseline, 321±107 m; 6 months, 324±116 m;P<0.001 between groups). Similarly, the five times sit-to-stand test time improved in the exercise group (mean time±SD: baseline, 20.5±6.0 seconds; 6 months, 18.2±5.7 seconds) but not in the control group (baseline, 20.9±5.8 seconds; 6 months, 20.2±6.4 seconds;P=0.001 between groups). The cognitive function score (P=0.04) and quality of social interaction score (P=0.01) in the kidney disease component of the KDQOL-SF improved significantly in the exercise arm compared with the control arm. Hence, a simple, personalized, home-based, low-intensity exercise program managed by dialysis staff may improve physical performance and quality of life in patients on dialysis.
authors.affiliation: Department of Biomedical and Surgical Specialties Sciences, Section of Sport Sciences and.|Vascular Diseases Center, University of Ferrara, Ferrara, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Manfredini
authors.affiliation: Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy.|Nephrology, Dialysis and Renal Transplantation Unit, Ospedali Riuniti, Reggio Calabria, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Mallamaci
authors.affiliation: Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: D'Arrigo
authors.affiliation: Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Baggetta
authors.affiliation: Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Bolignano
authors.affiliation: Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Torino
authors.affiliation: Department of Biomedical and Surgical Specialties Sciences, Section of Sport Sciences and.
authors.forename: Nicola
authors.initials: N
authors.lastname: Lamberti
authors.affiliation: Nephrology and Dialysis Unit, IRCCS Multimedica-Policlinico Multispecialistico, Milan, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Bertoli
authors.affiliation: Nephrology and Dialysis Unit, IRCCS Multimedica-Policlinico Multispecialistico, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Ciurlino
authors.affiliation: Nephrology and Dialysis Unit, IRCCS Multimedica-Policlinico Multispecialistico, Milan, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Rocca-Rey
authors.affiliation: Nephrology Unit, AOU Ferrara Arcispedale Sant' Anna, Ferrara, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Barillà
authors.affiliation: Nephrology Unit, AOU Ferrara Arcispedale Sant' Anna, Ferrara, Italy.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Battaglia
authors.affiliation: Nephrology and Dialysis Unit, Ospedale Civile, Imola, Italy.
authors.forename: Renato Mario
authors.initials: RM
authors.lastname: Rapanà
authors.affiliation: Nephrology and Dialysis Unit, Ospedale Civile, Imola, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Zuccalà
authors.affiliation: Azzurra Medical Nephrological Ambulatory and Dialysis Techniques, Catania, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: Bonanno
authors.affiliation: Department of Internal Medicine and Nephrology chair, University of Catania, Catania, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Fatuzzo
authors.affiliation: Department of Internal Medicine and Nephrology chair, University of Catania, Catania, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rapisarda
authors.affiliation: Department of Internal Medicine and Nephrology chair, University of Catania, Catania, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Rastelli
authors.affiliation: Nephrology and Dialysis Unit, IRCCS Cà Granda Ospedale Maggiore-Policlinico, Milano, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fabrizi
authors.affiliation: Nephrology and Dialysis Unit, IRCCS Cà Granda Ospedale Maggiore-Policlinico, Milano, Italy.
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
authors.affiliation: Nephrology and Dialysis Unit, Ospedale Pugliese-Ciaccio, Catanzaro, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: De Paola
authors.affiliation: Nephrology and Dialysis Unit, Ospedale Pugliese-Ciaccio, Catanzaro, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Lombardi
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Adamasco
authors.initials: A
authors.lastname: Cupisti
authors.affiliation: Nephrology and Dialysis Unit, Policlinico Universitario Mater Domini, Catanzaro, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Fuiano
authors.affiliation: Nephrology and Dialysis Unit, Policlinico Universitario Mater Domini, Catanzaro, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lucisano
authors.affiliation: Nephrology and Dialysis Unit, Policlinico Universitario Mater Domini, Catanzaro, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Summaria
authors.affiliation: Vascular Diseases Center, University of Ferrara, Ferrara, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Felisatti
authors.affiliation: Vascular Diseases Center, University of Ferrara, Ferrara, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Pozzato
authors.affiliation: Vascular Diseases Center, University of Ferrara, Ferrara, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Malagoni
authors.affiliation: Department of Internal Medicine and Nephrology chair, University of Catania, Catania, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Castellino
authors.affiliation: Nephrology Unit, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy; and.
authors.forename: Filippo
authors.initials: F
authors.lastname: Aucella
authors.affiliation: Epidemiology Department, High Institute of Public Health-Alexandria University, Alexandria, Egypt.
authors.forename: Samar
authors.initials: S
authors.lastname: Abd ElHafeez
authors.affiliation: Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy.
authors.forename: Pasquale Fabio
authors.initials: PF
authors.lastname: Provenzano
authors.affiliation: Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tripepi
authors.affiliation: Nephrology Unit, AOU Ferrara Arcispedale Sant' Anna, Ferrara, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Catizone
authors.affiliation: Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy; carmine.zoccali@tin.it.
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
mesh_terms: D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011788:Quality of Life; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D016138:Walking
keywords: CKD; dialysis; exercise; physical functioning; rehabilitation; six minute walking test