Exercise as a Protective Cardiovascular Factor in ESRD Patients

Objective: The aim of the study was to show the effectiveness of Physical Activity (PA) during dialysis as a protective treatment against cardiovascular (CV) diseases. Methods: Eighty volunteer patients were included in this multicentric prospective study and followed for one year: 40 patients in the Exercise group (EX), 40 patients in the Control group (CON). CV risk factors: Total Cholesterol, HDL Cholesterol (HDL-c), LDL cholesterol (LDL-c), Triglycerides (TG) and Hemoglobin (Hb), were checked. The number of antihypertensive treatments and the Erythropoietin Stimulating Agent (ESA) required doses were collected. We noted for each group during the follow-up the number of hospitalizations for CV reasons. Results: We observed a slight decrease of total cholesterol in both groups, more important for EX (1.82 ± 0.47 at M0 (Month 0), 1.74 ± 0.51 at M12 (Month 12) than for CON (1.60 ± 0.26 at M0; 1.63 ± 0.45 at M12). HDL-c increased in both groups, but LDL-c decreased in EX and increased in CON. The TG decreased in both groups after one year. The Hb level remained more stable in the EX group (11.70 ± 1.17 to 12.06 ± 1.11, p < 0.05) than in the CON group (11.79 ± 1.01 (M0) and 11.35 ± 1.21 (M12)). There was a significant difference between EX and CON at M12 (respectively 12.06 ± 1.11 vs. 11.35 ± 1.21). At the same time, the required doses of Erythropoietin Stimulating Agent (ESA) decreased in EX and increased in CON. The number of antihypertensive drugs per patient decreased significantly (p < 0.05) in the EX group between M0 and M12 (1.85 ± 1.08 at M0 and 1.55 ± 0.85 at M12). The EX patients were 3 times less frequently hospitalized for cardiovascular reasons. There were 3 hospital stays versus 20 for the CON group. Conclusion: Our study demonstrates that an intradialytic aerobic cycling training program promotes beneficial effects on cardiovascular protection: Lipids control, HTA control and Hb stability. Physical Activity although reduced the CV events in our population during one year follow-up.