Exercise Preconditioning to Protect Against Dialysis-induced Cardiac Injury

Exercise Preconditioning to Protect Against Dialysis-induced Cardiac Injury in Hemodialysis Patients: a Randomized Controlled Trial

The goal of this study is to determine what happens to the heart muscle contraction when people cycle before their hemodialysis treatment. Will pre-dialysis exercise protect the heart from a decrease in pumping of the heart muscle (called stunning) that can happen during hemodialysis. We will study whether pre-dialysis exercise decreases heart stunning, decreases the number and severity of symptoms commonly associated with hemodialysis, and other outcomes

This will be the first randomized crossover-controlled trial with two experimental conditions assessing the impact of exercise preconditioning in the HD population. If proven effective exercise preconditioning could be developed as a therapeutic option to reduce rates of heart failure in the dialysis population.

Inclusion Criteria:

• must be on chronic hemodialysis for at least 3 months
• age 18 years or older
• willing and able to provide informed consent
• assessed to be safe and able to exercise by unit HD Nephrologist

Exclusion Criteria:

• regular vigorous exercise outside of hemodialysis
• over 79 years of age
• intradialytic exercise < 3 months
• poor echogenicity
• acute coronary syndrome in the past 3 months
• unstable arrhythmia/angina
• shortness of breath at rest or with minimal activity
• symptomatic hypoglycemia (>2x/week in the week prior to enrolment)