Graded, rating-guided intradialytic resistance exercise produced clear acute dose-response haemodynamic and perceptual changes, supporting supervised individualisation of acute exercise dose but not establishing long-term safety or superiority of higher perceived-intensity training.
Higher perceived intensity intradialytic resistance exercise increased systolic blood pressure by 14.9 mmHg compared with control.
Higher perceived intensity exercise increased diastolic blood pressure by 8.4 mmHg compared with control.
Heart rate increased by 15.5 beats per minute at higher perceived intensity compared with control.
Rating of perceived exertion increased by 6.7 points on the Borg CR-10 scale at higher perceived intensity compared with control.
Peripheral oxygen saturation remained within safe limits throughout all exercise conditions.
Symptoms were recorded in 13 out of 48 higher perceived-intensity sessions, with no serious adverse events occurring.
A randomised crossover trial design was used in which participants completed both a seated control condition and graded lower-limb resistance exercise.
This research suggests that exercise performed during haemodialysis (the process of filtering blood in patients with kidney failure) can be safely graded in intensity using a perceived effort scale, and that doing so produces predictable, dose-dependent changes in blood pressure, heart rate, and perceived effort. The study had 48 stable haemodialysis patients perform seated leg resistance exercises at three different effort levels during their dialysis sessions, and compared their responses to a control session where they just sat quietly. As exercise intensity increased, blood pressure and heart rate rose in a consistent, stepwise fashion, and blood oxygen levels stayed in a healthy range throughout. The study found that even at higher exercise intensities, no serious adverse events occurred, though about one in four higher-intensity sessions did produce some minor symptoms. This suggests that using a patient's own perceived effort rating to guide exercise intensity during dialysis is a practical and reasonably safe approach for individualising exercise prescription in this population. The fact that responses were predictable and proportional to intensity supports the idea that clinicians can use effort ratings to tailor exercise dose to individual patients. However, this research only examined immediate (acute) responses during a single session, and the authors caution that these findings do not establish whether higher-intensity intradialytic exercise is better or safer over the long term compared with lower-intensity approaches. Further research with longer follow-up periods would be needed to understand the sustained benefits and risks of different exercise intensities during haemodialysis.
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Upload Your LabsHmida M, Abouzida M, Bardiaa Y, Abed K. (2026). Acute Haemodynamic and Perceptual Responses to Graded Intradialytic Exercise in Patients on Maintenance Haemodialysis: A Randomised Crossover Trial.. Journal of renal care. https://doi.org/10.1111/jorc.70081