Exercise Preconditioning to Protect Against Dialysis-induced Cardiac Injury

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Status: Enrolling

Conditions: Hemodialysis; Cardioprotection

Treatments: Other: Intradialytic Cycling

Study type: Interventional

Funder types: Other

Identifiers

NCT06735378

15393

Details and patient eligibility

About

The goal of this study is to determine what happens to the heart muscle contraction when people cycle before their hemodialysis treatment. Will pre-dialysis exercise protect the heart from a decrease in pumping of the heart muscle (called stunning) that can happen during hemodialysis. We will study whether pre-dialysis exercise decreases heart stunning, decreases the number and severity of symptoms commonly associated with hemodialysis, and other outcomes

Full description

This will be the first randomized crossover-controlled trial with two experimental conditions assessing the impact of exercise preconditioning in the HD population. If proven effective exercise preconditioning could be developed as a therapeutic option to reduce rates of heart failure in the dialysis population.

Enrollment: 30 estimated patients

Sex: All

Ages: 18 to 79 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• must be on chronic hemodialysis for at least 3 months
• age 18 years or older
• willing and able to provide informed consent
• assessed to be safe and able to exercise by unit HD Nephrologist

Exclusion criteria

• regular vigorous exercise outside of hemodialysis
• over 79 years of age
• intradialytic exercise < 3 months
• poor echogenicity
• acute coronary syndrome in the past 3 months
• unstable arrhythmia/angina
• shortness of breath at rest or with minimal activity
• symptomatic hypoglycemia (>2x/week in the week prior to enrolment)

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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30 participants in 2 patient groups

Randomization Order 1

Experimental group

Description:

Participants will be randomized into one of the two groups indicating the order in which they will receive the exercise intervention. Randomization Order 1 will receive the exercise treatment on the first day of the first week of the study. The other three days without exercise will consist of standard dialysis sessions with study procedures.

Treatment:

Other: Intradialytic Cycling

Randomization Order 2

Experimental group

Description:

Participants will be randomized into one of the two groups indicating the order in which they will receive the exercise intervention. Randomization Order 2 will receive the exercise treatment on the first day of the fourth week of the study. The other three days without exercise will consist of standard dialysis sessions with study procedures.

Treatment:

Other: Intradialytic Cycling