Effects of Supervised Exercise Training on Erythrocyte Deformability in Hemodialysis Patients

This study evaluated red blood cell function and aerobic capacity in adults receiving maintenance hemodialysis and in healthy reference participants. Participants receiving hemodialysis were included in either a supervised exercise training group or a usual-care group. The supervised exercise program combined resistance and aerobic exercise performed before hemodialysis. Participants in the exercise group completed repeated assessments across a non-exercise observation period, exercise training, and post-training follow-up. The usual-care group continued usual care without supervised exercise training, and healthy participants served as a reference group. Assessments included cardiopulmonary exercise testing and blood sampling to evaluate aerobic capacity, red blood cell deformability, and red blood cell characteristics related to membrane function, cell shape, oxidative stress, and calcium-related responses.

Inclusion Criteria: * Age 20 years or older * For participants with end-stage renal disease: maintenance hemodialysis for more than 6 months, clinically stable during the previous 3 months, stable medical treatment for at least 6 weeks, nephrologist approval for participation, and Kt/V \>1.2. * For healthy reference participants: no history of kidney disease. * Willingness to provide written informed consent. Exclusion Criteria: * Hyperkalemia within the previous 3 months. * Orthopedic disease, muscle weakness, or other medical, physiological, or psychological conditions preventing exercise training or exercise testing. * Pregnancy or planned pregnancy within 1 year. * Implanted cardiac devices that prevented achievement of the heart rate required for exercise training. * Cardiovascular, metabolic, or other clinical contraindications to exercise testing or training.