Exercise as an adjunctive therapy for patients on maintenance hemodiafiltration
Bibliographic record
Abstract
BACKGROUND: Fatigue and sedentarism are common in kidney disease and dialysis treatment. Although hemodiafiltration effectively removes solutes and improves mortality, the influence of exercise as an adjunct therapy on maintenance hemodiafiltration programs remains understudied. METHODS: A multicenter 6-month study was assessed comparing individuals with chronic kidney disease enrolled in exercise training (exercise group) during dialysis (intradialytic vs. interdialytic) compared to usual care (control group). Physical tests included a YMCA step test for endurance, handgrip, and one-repetition maximum for muscle strength. Single-pool, standard, and equilibrated Kt/Vurea were surrogates for hemodiafiltration adequacy. RESULTS: Eighty-nine patients (aged 54 ± 15 years) and 33 control patients (aged 60 ± 17 years) underwent the exercise protocol. The mean disease vintage was 108 ± 84 and 132 ± 108 months, respectively, while the dialysis vintage was 60 ± 42 and 60 ± 36 months. Control-group Kt/Vurea showed improvement from baseline to month 6 (single-pool, 1.18 ± 0.03 to 1.30 ± 0.04; standard, 1.94 ± 0.04 to 2.09 ± 0.04; equilibrated, 1.09 ± 0.03 to 1.21 ± 0.02; p < 0.001). However, exercise-group Kt/Vurea showed a comparatively greater improvement between the baseline and month 6 (single pool, 1.19 ± 0.05 to 1.47 ± 0.04; standard, 1.99 ± 0.03 to 2.15 ± 0.03; equilibrated, 1.08 ± 0.03 to 1.24 ± 0.03; p < 0.001). The exercise group had a statistically significant increase in the handgrip test (279.5 ± 78.5 N to 295.2 ± 76.5 N, p < 0.01) and fat-free mass (13.9 ± 2.8 kg/m2 to 14.4 ± 2.7 kg/m2, p < 0.01). There were no statistically significant differences between the interdialytic and intradialytic groups in dialysis adequacy and exercise variables. CONCLUSION: Supervised exercise for maintenance hemodiafiltration patients was associated with improvements in dialysis efficiency/ performance outcomes. The results support exercise as an adjunct therapy for hemodiafiltration patients whether conducted during the intradialytic or interdialytic period.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".