Endurance-oriented training program with children and adolescents on maintenance hemodialysis to enhance dialysis efficacy-DiaSport.

Autor:	Feldkötter M; Pediatric Nephrology Unit, University Children's Hospital Zurich, Zurich, Switzerland., Thys S; Institute of Sport Science, Bundeswehr University Munich, Munich, Germany., Adams A; Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, Cologne, Germany., Becker I; Institute of Medical Statistics and Computational Biology, University Hospital of Cologne, Cologne, Germany., Büscher R; Pediatric Nephrology, Pediatrics II, University of Duisburg-Essen, Essen, Germany., Pohl M; Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany., Schild R; Pediatric Nephrology, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Pape L; Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany., Schmitt CP; Division of Pediatric Nephrology, Center for Pediatric and Adolescent Medicine, Heidelberg, Germany., Taylan C; Pediatric Nephrology, Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany., Wygoda S; KfH Center of Pediatric Nephrology, St Georg Hospital, Leipzig, Germany., Klaus G; KfH Center of Pediatric Nephrology, Department of Pediatric Nephrology, Marburg, Germany., Fehrenbach H; Pediatric Nephrology, Children's Hospital, Memmingen, Germany., Montoya C; KfH Center of Pediatric Nephrology, Children's Hospital Munich Schwabing, Munich, Germany., Konrad M; Department of General Pediatrics, University Children's Hospital, Münster, Germany., Billing H; University Children's Hospital, Tübingen, Germany., Schaar B; Institute of Sport Science, Bundeswehr University Munich, Munich, Germany., Hoppe B; Children's Hospital, University of Bonn, Bonn, Germany. bernd.hoppe@knz-bonn.de.; Kindernierenzentrum Bonn, Bonn, Germany. bernd.hoppe@knz-bonn.de.
Jazyk:	angličtina
Zdroj:	Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2021 Dec; Vol. 36 (12), pp. 3923-3932. Date of Electronic Publication: 2021 Jun 12.
DOI:	10.1007/s00467-021-05114-8
Abstrakt:	Objective: Pediatric patients spend significant time on maintenance hemodialysis (HD) and traveling. They are often not capable of participating in sports activities. To assess the effects of exercise training during HD on dialysis efficacy in children and adolescents, we set up a multi-center randomized controlled trial (RCT). Methods: Patients on HD, age 6 to 18 years, were randomized either to 3× weekly bicycle ergometer training or to no training during HD for 12 weeks. Change in single-pool Kt/V (spKt/V) was the primary outcome parameter. Results: We randomized 54 patients of whom 45 qualified (23 in the intervention and 22 in the waiting control group, 14.5 ± 3.01 years, 32 male and 13 female) for the intention-to-treat (ITT) population. Only 26 patients finished study per-protocol (PP). Training was performed for an average of 11.96 weeks (0.14-13.14) at 2.08 ± 0.76 times per week and for a weekly mean of 55.52 ± 27.26 min. Single-pool Kt/V was similar in the intervention compared to the control group (1.70 [0.33] vs. 1.79 [0.55]) at V0 and (1.70 [0.36] vs. 1.71 [0.51]) at V1; secondary endpoints also showed no difference in both ITT and PP analysis. No significant adverse events were reported. No bleeding or needle dislocation occurred in 1670 training sessions. Conclusions: Intradialytic bicycle training is safe, but does not improve dialysis efficacy and physical fitness. However, the study can be considered underpowered, particularly because of high dropout rates. Future studies need better strategies to increase motivation and compliance and other more effective/intensive exercise measures should be evaluated. Trial Registration: The trial was registered in ClinicalTrials.Gov ( Clinicaltrials.gov identifier: NCT01561118) on March 22, 2012. (© 2021. The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu Plný text ve formátu PDF