Hemodynamic Instability during Dialysis: The Potential Role of Intradialytic Exercise

MCGUIRE, S., HORTON, E.J., RENSHAW, D., JIMENEZ GUTIERREZ, Alfonso, KRISHNAN, N. and MCGREGOR, G. (2018). Hemodynamic Instability during Dialysis: The Potential Role of Intradialytic Exercise. BioMed Research International, 2018.

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Link to published version:: https://doi.org/10.1155/2018/8276912


© 2018 Scott McGuire et al. Acute haemodynamic instability is a natural consequence of disordered cardiovascular physiology during haemodialysis (HD). Prevalence of intradialytic hypotension (IDH) can be as high as 20-30%, contributing to subclinical, transient myocardial ischemia. In the long term, this results in progressive, maladaptive cardiac remodeling and impairment of left ventricular function. This is thought to be a major contributor to increased cardiovascular mortality in end stage renal disease (ESRD). Medical strategies to acutely attenuate haemodynamic instability during HD are suboptimal. Whilst a programme of intradialytic exercise training appears to facilitate numerous chronic adaptations, little is known of the acute physiological response to this type of exercise. In particular, the potential for intradialytic exercise to acutely stabilise cardiovascular hemodynamics, thus preventing IDH and myocardial ischemia, has not been explored. This narrative review aims to summarise the characteristics and causes of acute haemodynamic instability during HD, with an overview of current medical therapies to treat IDH. Moreover, we discuss the acute physiological response to intradialytic exercise with a view to determining the potential for this nonmedical intervention to stabilise cardiovascular haemodynamics during HD, improve coronary perfusion, and reduce cardiovascular morbidity and mortality in ESRD.

Item Type: Article
Uncontrolled Keywords: Cardiovascular Diseases; Cardiovascular System; Exercise; Hemodynamics; Humans; Renal Dialysis; Cardiovascular System; Humans; Cardiovascular Diseases; Exercise; Renal Dialysis; Hemodynamics; 06 Biological Sciences; 08 Information and Computing Sciences; 10 Technology
Identification Number: https://doi.org/10.1155/2018/8276912
SWORD Depositor: Symplectic Elements
Depositing User: Symplectic Elements
Date Deposited: 18 May 2021 12:02
Last Modified: 18 May 2021 12:15
URI: https://shura.shu.ac.uk/id/eprint/26526

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