Exercise in patients on dialysis: A multicenter, randomized clinical trial

F. Manfredini, F. Mallamaci, G. D’Arrigo, R. Baggetta, D. Bolignano, C. Torino, N. Lamberti, S. Bertoli, D. Ciurlino, L. Rocca-Rey, A. Barillà, Y. Battaglia, R.M. Rapanà, A. Zuccalà, G. Bonanno, P. Fatuzzo, F. Rapisarda, S. Rastelli, F. Fabrizi, P. MessaL.D. Paola, L. Lombardi, A. Cupisti, G. Fuiano, G. Lucisano, C. Summaria, M. Felisatti, E. Pozzato, A.M. Malagoni, P. Castellino, F. Aucella, S.A. Elhafeez, P.F. Provenzano, G. Tripepi, L. Catizone, C. Zoccali

Research output: Contribution to journalArticlepeer-review


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 (exercise n=104; control n=123) repeated the 6-month evaluations. The distance covered during the 6-minute walking test improved in the exercise group (mean distance6SD: baseline, 328696 m; 6 months, 3676113 m) but not in the control group (baseline, 3216107 m; 6 months, 3246116 m; P,0.001 between groups). Similarly, the five times sit-to-stand test time improved in the exercise group (mean time6SD: baseline, 20.566.0 seconds; 6 months, 18.265.7 seconds) but not in the control group (baseline, 20.965.8 seconds; 6 months, 20.266.4 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. Copyright © 2017 by the American Society of Nephrology well documented,5 how exercise training should be articulated
Original languageEnglish
Pages (from-to)1259-1268
Number of pages10
JournalJournal of the American Society of Nephrology
Issue number4
Publication statusPublished - 2017


  • albumin
  • calcium
  • cholesterol
  • creatinine
  • glucose
  • parathyroid hormone
  • phosphate
  • triacylglycerol
  • urea
  • adult
  • arm exercise
  • Article
  • clinical assessment
  • cognition
  • comparative study
  • continuous ambulatory peritoneal dialysis
  • controlled study
  • exercise
  • exercise test
  • female
  • functional status
  • hemodialysis
  • home care
  • human
  • kidney disease
  • Kidney Disease Quality of Life Short Form questionnaire
  • major clinical study
  • male
  • managed care
  • multicenter study
  • outcome assessment
  • personalized walking exercise program
  • physical activity
  • physical capacity
  • physical performance
  • priority journal
  • quality of life
  • questionnaire
  • randomized controlled trial
  • sit to stand test
  • six minute walk test
  • social interaction
  • time to treatment
  • urinary tract disease assessment
  • walking
  • clinical trial
  • fitness
  • kinesiotherapy
  • middle aged
  • multimodality cancer therapy
  • Renal Insufficiency, Chronic
  • Combined Modality Therapy
  • Exercise Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physical Fitness
  • Quality of Life
  • Renal Dialysis
  • Walking


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