MP465INTRADIALYTIC EXERCISE: A NON-PHARMACOLOGICAL SOLUTION TO A URAEMIC PROBLEM?

Abstract

INTRODUCTION AND AIMS: In patients undergoing maintenance haemodialysis (HD), symptom burden is comparable with other advanced chronic diseases such as terminal cancer. Increasing symptom burden in HD patients has been shown to lead to a poorer quality of life and comorbidities such as depression or anxiety. Intradialytic exercise (IE) programmes are an emerging therapeutic intervention, which may abrogate some of these patient symptoms. Few studies have examined the effects upon patient symptomatology and how this may affect self-reported quality of life. We aimed to determine the effects of a 3 month IE programme upon the quality of life and uraemic symptomatology in HD patients. METHODS: 47 prevalent HD patients were randomised into a 6 month programme of intradialytic exercise (EX) or into a usual care control (CON) group, of which we will present the 3 month interim data. IE was aerobic, and performed thrice weekly for 30 minutes at a moderate intensity (RPE 12-14). Patients completed the Palliative Care Outcome Scale Renal Version (POS-SR), EuroQol Five Dimensions Questionnaire (EQ5D) and Hospital Anxiety and Depression Scale (HADS) at baseline (BASE) and at 3 months (3M). ANOVA was performed on HADS and EQ5D data to assess any significant time x group interaction effects. Chi-squared tests were performed to assess changes in symptomatology. Statistical significance was accepted at P < 0.05 level. RESULTS: There was a significant reduction in itching reported in the EX group, whilst the CON group experienced worsening of this symptom. There was a mean improvement across HADS scores in the EX group, which was statistically significant for anxiety and a trend to significance overall. There was no significant time x group interaction effect on EQ5D scores and no significant changes occurred in any other symptoms assessed by POS-SR. See table below. CONCLUSIONS: IE may improve self-reported anxiety symptoms. It also improved itching, which previous studies have shown to be both highly prevalent and intrusive in this patient population. Current treatment options for itching in HD patients are both difficult and ineffective. To our knowledge, this is the first study assessing the effectiveness of IE in reducing itching; these data will be further evaluated over 6 months as part of the CYCLE-HD trial. (Table Presented).