The Acute, Combined, and Separate Effects of Cold Hemodialysis and Intradialytic Exercise in Insulin Sensitivity and Glucose Disposal

ASAIO J. 2024 May 1;70(5):436-441. doi: 10.1097/MAT.0000000000002117. Epub 2024 Jan 23.

Abstract

Hemodialysis (HD) patients suffer from multiple health problems, including severe insulin resistance. Both cold dialysis and intradialytic exercise training could elicit health benefits; however, it is still unknown whether the combination of those two approaches could enhance overall health. The current study aimed to evaluate the separate and combined acute effects of a single session of cold dialysis and intradialytic exercise in parameters related to insulin sensitivity and glucose disposal. Ten HD patients (57.2 ± 14.9 years) participated in the study. Each patient participated in four different scenarios during HD: a) typical dialysis with dialysate temperature at 37°C (TD), b) cold dialysis with dialysate temperature at 35°C, c) typical HD combined with a single exercise bout, d) cold dialysis combined with a single exercise bout. Glucose disposal and insulin resistance were assessed immediately after the end of the HD session. None of the examined parameters significantly differed between the four scenarios ( p > 0.05). However, slight numerical changes and moderate to high effect size ( d : 0.50-0.85) were observed between TD versus cold dialysis and TD versus TD + exercise in glucose and insulin disposal rates. A single session of cold and TD with intradialytic exercise may provide an "acute" time-efficient stimulus for consecutively improving glucose disposal and insulin sensitivity.

Trial registration: ClinicalTrials.gov NCT03905551.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Cold Temperature*
  • Exercise* / physiology
  • Female
  • Glucose / metabolism
  • Humans
  • Insulin / blood
  • Insulin Resistance* / physiology
  • Male
  • Middle Aged
  • Renal Dialysis* / adverse effects
  • Renal Dialysis* / methods

Substances

  • Blood Glucose
  • Glucose
  • Insulin

Associated data

  • ClinicalTrials.gov/NCT03905551