Author(s): BOGATAJ, S., ROELANDS, B., PAJEK, M., PAJEK, J., Institution: UNIVERSITY MEDICAL CENTRE LJUBLJANA, Country: SLOVENIA, Abstract-ID: 479

INTRODUCTION:
Hemodialysis (HD) patients are at risk of frailty, sarcopenia, and cognitive decline, which affect their overall quality of life (QoL) and increases the risk of morbidity and mortality. One important blood parameter inducing this, and that has been shown to be affected by HD, is brain-derived neurotrophic factor (BDNF). BDNF plays a vital role in neuronal survival, synaptic plasticity, and energy metabolism. This study aimed to determine the impact of sequential physical and cognitive intradialytic training on functional and physiological status of HD patients.
METHODS:
Thirty-two HD patients were randomly divided into an experimental (EXP) and control (CON) group. The EXP group underwent 12 weeks of intradialytic cycling and cognitive training three times a week, while the CON group received standard care. Outcome measures (serum BDNF concentrations, subjective feeling of mental fatigue, frailty score, QoL (Physical Component Summary (PCS) and Mental Component Summary (MCS)) were assessed before and after the intervention.
RESULTS:
A significant between-group difference was found for subjective feeling of mental fatigue (F(1,29)=9.74, p=0.004) and frailty score (F(1,29)=12.26, p=0.002) favoring the EXP group, whereas no significant differences were observed for BDNF (F(1,29)=2.15, p=0.153), PCS (F(1,29)=1.52, p=0.227) and MCS (F(1,29)=1.27, p=0.270). BDNF concentrations were preserved in the EXP group, while a significant decrease was observed in the CON group (p=0.006). There was a significant correlation between the change in BDNF and change in mental fatigue (r=-0.554; p=0.001). The frailty score significantly increased in the CON group (p=0.011), while it remained stable in the EXP group. PCS was improved within the EXP group (p=0.040).
CONCLUSION:
The study provides evidence for the effectiveness of a novel non-pharmacological intervention for HD patients. By targeting both physical and cognitive aspects, this intervention holds promise for improving their functional status. Further research is needed to explore the long-term benefits of such interventions and understand their potential impact on QoL.