***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: INTRODUCTION Hemodialysis contributes to increased oxidative stress and induces transitory hypoxemia . Compartmentalization decreases the supply of solutes to the dialyzer during treatment . The aim of this study was to investigate the acute effects of intradialytic aerobic exercise on solute removal , blood gases and oxidative stress in patients with chronic kidney disease during a single hemodialysis session . METHODS Thirty patients were r and omized to perform aerobic exercise with cycle ergometer for lower limbs during 30 minutes with intensity between 60 - 70 % of maximal heart rate , or control group ( CG ) . Blood sample s were collected prior to and immediately after exercise or the equivalent time in CG . Analysis of blood and dialysate biochemistry as well as blood gases were performed . Mass removal and solute clearance were calculated . Oxidative stress was determined by lipid peroxidation and by the total antioxidant capacity . RESULTS Serum concentrations of solutes increased with exercise , but only phosphorus showed a significant elevation ( p = 0.035 ) . There were no significant changes in solute removal and in the acid-base balance . Both oxygen partial pressure and saturation increased with exercise ( p = 0.035 and p = 0.024 , respectivelly ) , which did not occur in the CG . The total antioxidant capacity decreased significantly ( p = 0.027 ) . CONCLUSION The acute intradialytic aerobic exercise increased phosphorus serum concentration and decreased total antioxidant capacity , reversing hypoxemia result ing from hemodialysis . The intradialytic exercise did not change the blood acid-base balance and the removal of solutes BACKGROUND Individuals on hemodialysis have low physical function and activity levels . Clinical trials have shown improvements in these parameters with exercise programming . Pedometers have not been extensively evaluated in individuals on hemodialysis . This r and omized clinical trial compared the effects of intradialytic cycling versus a pedometer program on physical function , physical activity and quality of life . METHODS Sixty patients were r and omly assigned to two study groups . The ergometer group cycled during each hemodialysis session for 24 weeks . Pedometer participants followed a home-based walking program for 24 weeks . The primary outcome was aerobic capacity [ VO2peak and 6-minute walk ( 6MW ) test ] . Secondary outcomes included lower extremity strength [ sit-to-st and ( SS ) test ] , flexibility [ sit- and -reach ( SR ) test ] , physical activity ( accelerometer ) and health-related quality of life . Measurements were collected at baseline and at 12 and 24 weeks . RESULTS At 12 and 24 weeks , there was no significant change in the VO2peak or 6MW test between or within study groups . SS testing in the ergometer group improved from 10.2 ( SD 3.4 ) to 11.4 ( SD 2.5 ) cycles from baseline to 24 weeks ( P < 0.005 ) . Similarly , in the pedometer group , SS cycles improved from 10.1 ( SD 3.3 ) to 12.2 ( SD 3.5 ) ( P < 0.005 ) . The SR test also significantly improved over time in both the study groups . No significant changes were noted for other secondary outcomes . CONCLUSIONS Both intradialytic cycling and pedometer programming improved aspects of physical function . Neither intervention had a significant effect on aerobic capacity . No significant differences in any outcomes were identified between interventions groups OBJECTIVES The purpose of this study is to determine whether a low-to-moderate intensity pre-conditioning exercise programme linked with exercise counselling could improve behavioural change , physical fitness , physiological condition and health-related quality of life of sedentary haemodialysis patients in The Netherl and s. METHODS Ninety-six haemodialysis patients of the Groningen Dialysis Center were r and omized into an exercise group ( n = 53 ) and a control group ( n = 43 ) . The exercise programme consists of cycling during dialysis together with a pre-dialysis strength training programme lasting 12 weeks . The intensity of the exercise programme is condition level 12 - 16 according to the rate of perceived exertion ( RPE ) . Motivational interviewing techniques were used for exercise counselling . Before and after the intervention , both groups were tested on behavioural change and physical fitness components such as reaction time , manual dexterity , lower extremity muscle strength and VO2 peak . Physiological conditions such as weight , blood pressure , haemoglobin and haematocrit values , cholesterol and Kt/V were obtained from the medical records . Health-related quality of life assessment included R AND -36 scores , symptoms and depression . RESULTS A group x time analysis with MANOVA ( repeated measures ) demonstrates that participation in a low-to-moderate intensity exercise programme linked with exercise counselling yields a significant increase in behavioural change , reaction time , lower extremity muscle strength , Kt/V and three components of quality of life , and no significant effects in the control group . CONCLUSION Participating in a low-to-moderate intensity pre-conditioning exercise programme showed beneficial effects on behavioural change , physical fitness , physiological conditions and health-related quality of life In chronic kidney disease ( CKD ) , oxidative stress ( OS ) plays a central role in the development of cardiovascular diseases . This pilot program aim ed to determine whether an intradialytic aerobic cycling training protocol , by increasing physical fitness , could reduce OS and improve other CKD-related disorders such as altered body composition and lipid profile . Eighteen hemodialysis patients were r and omly assigned to either an intradialytic training ( cycling : 30 min , 55%-60 % peak power , 3 days/week ) group ( EX ; n = 8) or a control group ( CON ; n = 10 ) for 3 months . Body composition ( from dual-energy X-ray absorptiometry ) , physical fitness ( peak oxygen uptake and the 6-minute walk test ( 6MWT ) ) , lipid profile ( triglycerides ( TG ) , total cholesterol , high-density lipoprotein , and low-density lipoprotein ( LDL ) ) , and pro/antioxidant status ( 15-F2α-isoprostanes ( F2-IsoP ) and oxidized LDL in plasma ; superoxide dismutase , glutathione peroxidase , and reduced/oxidized glutathione in erythrocytes ) were determined at baseline and 3 months later . The intradialytic training protocol did not modify body composition but had significant effects on physical fitness , lipid profile , and pro/antioxidant status . Indeed , at 3 months : ( i ) performance on the 6MWT was increased in EX ( + 23.4 % , p < 0.001 ) but did not change in CON , ( ii ) plasma TG were reduced in EX ( -23 % , p < 0.03 ) but were not modified in CON , and ( iii ) plasma F2-IsoP concentrations were lower in EX than in CON ( -35.7 % , p = 0.02 ) . In conclusion , our results show that 30 min of intradialytic training , 3 times per week for 3 months , are enough to exert beneficial effects on the most sensitive and reliable marker of lipid peroxidation ( IsoP ) while improving CKD-associated disorders ( lipid profile and physical fitness ) . Intradialytic aerobic cycling training represents a useful and easy strategy to reduce CKD-associated disorders . These results need to be confirmed with a larger r and omized study AimS keletal muscle atrophy and dysfunction with associated weakness may involve the respiratory muscles of dialysis patients . We evaluated the effect of moderate-intensity exercise on lung function and respiratory muscle strength . Methods Fifty-nine patients ( 25 F , aged 65 ± 13 years ) from two centers participating in the multicenter r and omized clinical trial EXerCise Introduction To Enhance Performance in Dialysis ( EXCITE ) were studied . Subjects were r and omized into a prescribed exercise group ( E ) , wherein subjects performed two 10-min walking sessions every second day at an intensity below the self-selected speed , or a control group ( C ) with usual care . Physical performance was assessed by the  6-min walk test ( 6MWT  ) . Patient lung function and respiratory muscle strength were evaluated by spirometry and maximal inspiratory pressure ( MIP ) , respectively . Results Forty-two patients ( 14 F ) completed the study . At baseline , the groups did not differ in any parameters . In total , 7 patients ( 4 in E ; 3 in C ) showed an obstructive pattern . The pulmonary function parameters were significantly correlated with 6MWT but not with any biochemical measurements . Group E safely performed the exercise program . At follow-up , the spirometry parameters did not change in either group . A deterioration of MIP ( −7 % ; p = 0.008 ) was observed in group C , but not in group E ( + 3.3 % , p = ns ) . In E , an increase of 6MWT was also found ( + 12 vs. 0 % in C ; p = 0.038 ) . Conclusion In dialysis patients , a minimal dose of structured exercise improved physical capacity and maintained a stable respiratory muscle function , in contrast to the control group where it worsened OBJECTIVE To investigate if high-intensity constant work rate ( CWR ) would constitute a more appropriate testing strategy compared with incremental work rate ( IWR ) to assess the effectiveness of intradialytic aerobic training in patients with end-stage renal disease ( ESRD ) . DESIGN R and omized controlled trial . SETTING Nephrology unit at the university hospital . PARTICIPANTS Patients ( N=28 ; 47.0±11.9y ) under hemodialysis ( 4.4±4.3y ) were r and omly assigned to exercise and control groups . INTERVENTION Patients included in the exercise group underwent a moderate-intensity intradialytic aerobic training program 3 times per week for 12 weeks . MAIN OUTCOME MEASURES Cardiopulmonary and perceptual responses were obtained during an IWR and a high-intensity CWR test to the limit of tolerance on a cycle ergometer . RESULTS Training-induced increases in peak oxygen uptake ( Vo(2)peak ) and time to exercise intolerance ( Tlim ) . Mean improvement in Tlim ( 97.4%±75.6 % ) was significantly higher than increases in Vo(2)peak ( 12%±11.3 % ) ( P<.01 ) ; in fact , while Tlim improved 50 % to 200 % in 9 of 12 patients , Vo(2)peak increases were typically in the 15 % to 20 % range . CWR test revealed lower metabolic , ventilatory , cardiovascular , and subjective stresses at isotime ; in contrast , submaximal responses during the incremental work rate ( at the gas exchange threshold ) remained unaltered after training . CONCLUSIONS A laboratory-based measure of endurance exercise capacity ( high-intensity CWR test to Tlim ) was substantially more sensitive than oxygen uptake at the peak IWR test to unravel the physiologic benefits of an intradialytic aerobic training program in mildly impaired patients with ESRD Introduction Literature shows that patients undergoing hemodialysis present poor physical conditioning and low tolerance to exercise . They may also suffer from respiratory dysfunctions . The purpose of this study was to evaluate the effects of neuromuscular electrical stimulation on pulmonary function and functional capacity of patients with chronic kidney disease on hemodialysis . Methods Forty adult patients with chronic kidney disease on hemodialysis were prospect ively studied and r and omized into two groups ( control n = 20 and treatment n = 20 ) . The treatment group underwent bilateral femoral quadriceps muscles electrical stimulation for 30 minutes during hemodialysis , three times per week , for two months . The patients were evaluated by pulmonary function test , maximum respiratory pressures , maximum one-repetition test , and six-minute walk test ( 6MWT ) , before and after the treatment protocol . Results The treatment group presented increased maximum inspiratory ( MIP ) ( p = 0.02 ) and expiratory pressures ( MEP ) ( p < 0.0001 ) , muscular strength in maximum one-repetition test ( p < 0.001 ) , and distance covered in the 6MWT ( p = 0.03 ) , and decreased systolic blood pressure ( p < 0.001 ) and respiratory frequency ( p < 0.001 ) when compared with the control group . Conclusion Electrical neuromuscular stimulation had a positive impact on pulmonary function and functional capacity , leading to better physical performance in patients on hemodialysis Functional capacity of end-stage renal disease patients is dramatically impaired . Although exercise training programs appear to have beneficial morphological , functional and psychosocial effects in end-stage renal disease patients on hemodialysis ( HD ) , the adherence rate is high . The purpose of this study was to compare the effects of three modes of exercise training on aerobic capacity and to identify the most favourable , efficient and preferable to patients on HD with regard to functional improvements and participation rate in the programs . Fifty-eight volunteer patients were screened for low-risk status and selected from the dialysis population . The 48 patients who completed the study protocol were r and omly assigned either to one of the three training groups or to a control group .  Sixteen of them ( Group A - mean age 46.4+/-13.9 years ) completed a 6-month supervised outpatient exercise renal rehabilitation program consisting of three weekly sessions of aerobic and strengthening training on the non-dialysis days ; 10 ( Group B - mean age 48.3+/-12.1 years ) completed a 6-month exercise program during HD ; 10 ( Group C - mean 
    Output:
    
Thus , intradialytic exercise protocol s can improve cardiopulmonary function , exercise tolerance and ventilatory efficiency in chronic kidney disease patients