Effects of Intradialytic Exercise on Functional Capacity and Health‐Related Quality of Life in Hemodialysis Patients

BACKGROUND: Patients with chronic kidney failure often experience reduced physical function due to inactivity and arteriovenous fistula-related complications, negatively affecting quality of life. This study aimed to investigate the effect of intradialytic exercise on functional capacity, quality of life, fatigue, and depression in hemodialysis patients. METHODS: This was a prospective, randomized controlled trial including 72 hemodialysis patients (aged 18-80 years) undergoing treatment three times per week for at least 1 year. Participants were randomly assigned to an exercise group (mean age: 55.7 ± 12.0 years) or a control group (mean age: 54.6 ± 14.2 years). The exercise group performed supervised combined aerobic and resistance exercises during dialysis sessions, three times weekly for 8 weeks, while the control group received routine hemodialysis care. Outcomes were assessed at baseline and after 8 weeks using the Six-Minute Walk Test, Five-Repetition Sit-to-Stand Test, Kidney Disease Quality of Life-36 questionnaire, Visual Analog Scale for fatigue, Beck Depression Inventory. RESULTS: Fifty-nine patients completed the study (exercise group: n = 30; control group: n = 29). Both groups were similar at baseline. Post-intervention, the exercise group demonstrated significant improvements in physical performance (p = 0.046), quality of life subdomains (p < 0.05), and depression (p < 0.001), whereas no significant change was observed in functional capacity (p = 0.627) or fatigue (p = 0.537). In contrast, the control group demonstrated declines in several quality of life subdomains (p < 0.05), with significant worsening in fatigue (p = 0.011) and depression (p = 0.011). CONCLUSIONS: Intradialytic exercise is an effective intervention to improve physical and psychological outcomes in hemodialysis patients, suggesting its integration into routine dialysis care may help mitigate progressive functional decline. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05246956.