Patients on peritoneal dialysis likely to benefit from exercise, physical activity
Patients receiving peritoneal dialysis report few adverse events from exercise or physical activity interventions and are likely to benefit from these, according to data published in Peritoneal Dialysis International.
“The on-going uncertainty regarding safety to exercise is a barrier reported by both people receiving peritoneal dialysis (PD) and clinicians. Studies have speculated that risk of adverse events may be increased for people receiving PD therefore consequently, a conservative approach may be to encourage people receiving peritoneal dialysis not to engage in exercise or physical activity, preventing people from receiving the wonderful health benefits that can come with engaging in an active lifestyle,” Brett Dean Tarca, AEP, AES, ESSAM, a PhD candidate and an exercise physiologist at the University of South Australia, told Healio. “We aimed to identify if there were any indications that risk of harm was increased for people receiving PD to assist clinicians in making informed decisions regarding exercise safety considerations and, increase confidence of people receiving PD and clinicians.”
In a systematic review, researchers examined 17 exercise or physical activity intervention studies involving adults on PD. A total of 287 patients participated in an exercise or physical activity intervention that ranged from 4 weeks to 52 weeks.
Of the studies evaluated, 35% prescribed aerobic exercise alone, 23% prescribed aerobic exercise with resistance training, 12% prescribed resistance training, 12% prescribed flexibility training, 12% prescribed general exercise and 6% prescribed anaerobic exercise alone. Researchers calculated rate of adverse events per person, per week by diving the total number of adverse events by the total number of patients and the total amount of intervention weeks.
Analyses revealed a total of 50 adverse events were reported from 263 intervention weeks. Thirty-two events were attributed to exercise or physical activity interventions at a rate of 0.08 adverse events, per 100 people, per intervention week. Most events were resolved by exercise modification, education, rest or medication; however, no patients reported serious adverse events due to interventions.
“Based on the available studies, this is the strongest indication to date that the risk for adverse events for people receiving PD who engage in exercise or physical activity is low. Previously hypothesized PD-specific adverse events (pulling, leaks, infection) or serious adverse events (death, hospitalization) were not reported as attributable to the intervention. These results should increase confidence for clinicians and patients that people receiving PD can and should be engage in an active lifestyle safely,” Tarca told Healio. “It’s no secret that the number of exercise/physical activity interventional studies is limited in this cohort. We need more interventional data so that robust guidelines for exercise can be developed. In the short term, further collecting of exercise or physical activity-related adverse event data from people receiving PD will build on this research and, hopefully, mitigate the barriers and enhance confidence.”