Resistance Training Improves Fluid Imbalance Symptoms in Hemodialysis Patients: A Randomized Controlled Trial
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Abstract
Introduction: Fluid imbalance contributes to symptoms such as intradialytic hypotension, muscle cramps, and dyspnea in hemodialysis patients. Exercise therapy may reduce these symptoms, but data on structured resistance training remain limited. This randomized controlled trial evaluated the effect of resistance training on fluid imbalance–related symptoms.
Materials and Methods: Twenty-six adult hemodialysis patients were randomized 1:1 to either resistance training plus lifestyle advice or lifestyle advice alone. The intervention consisted of 20-minute resistance training sessions performed three times weekly for 20 weeks. Outcomes included intradialytic muscle cramps, exertional dyspnea (NYHA class), intradialytic dyspnea (Borg scale), and body composition variables. Linear mixed-effects models were used to assess changes over time. Ethical approval was obtained (IR.SBMU.MSP.REC.1402.531). All participants provided written informed consent.
CONSORT checklist completed; CONSORT flow diagram referenced.
Results: Twenty-six participants completed the study. The intervention group experienced significant reductions in muscle cramps (β = −1.993, p = 0.024), exertional dyspnea (β = −1.443, p = 0.019), and intradialytic dyspnea (β = −2.275, p < 0.001). No significant changes were observed in skeletal muscle mass or total body water. No major adverse events occurred.
Discussion: Resistance training effectively improved fluid imbalance–related symptoms and was safe and feasible among hemodialysis patients. These findings support incorporating resistance training into dialysis care to improve symptom burden and clinical tolerance.
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