Study at 21 dialysis centers: Kidney patients benefit from physical exercises

Exercise during dialysis has positive health impact

Approximately 1,000 patients at 21 dialysis centers in Germany took part in the study, which has been published in the New England Journal of Medicine – Evidence. “We mounted one of the world’s largest studies on physical activity in the context of specific diseases,” says Martin Halle. Data from health insurance providers was consulted to ensure that the participant pool was representative of dialysis patients in Germany in terms of aspects such as age, gender and overall health.

Over a twelve-month period, half of the study participants completed accompanied exercise sessions at least once and ideally three times per week alongside their dialysis, while others were subject only to medical monitoring. These sessions included 30 minutes of endurance training with a bed-cycle ergometer and a further 30 minutes of exercises with weights, resistance bands and balls. The exercises were tailored to each patient’s ability.

After a year, the health of the study’s active participants had improved significantly. This included completing more repetitions in a one-minute sit-to-stand test and walking further in six minutes than at the start of the study. In the control group, these values were even lower at the end of the study period than at the outset.

“This type of standardized testing may admittedly not appear to be particularly reflective of everyday life,” says Martin Halle. “However, the results demonstrate tangible improvements in quality of life and autonomy. For example, the participants were able to stand up from a chair at home without assistance, which was not always the case beforehand.” There are other signs of the training program’s positive effects: participants who completed regular training sessions spent an average of two days in hospital during the study, compared to an average of five days for the control group.

“To my mind, the results speak for themselves,” says Martin Halle. “We were able to improve the participants’ health and also reduce the costs to the healthcare system with relatively little outlay.” The researchers’ figures suggest that the costs for personalized training would be around €25 per session per person.

The DiaTT (Dialysis Training Therapy) consortium submitted the final report to the Federal Joint Committee (Gemeinsamer Bundesausschuss – G-BA), which had financed the study through its Innovation Fund (Innovationsfonds). This committee will ultimately determine whether this training is offered to all dialysis patients with statutory health insurance in Germany. “I hope our exercise program will become standard in statutory health insurance,” says Martin Halle. “Our study shows how important it is to adopt a holistic view of health, especially when it comes to elderly and infirm patients. While high-tech medicine is important, it can only achieve its full potential in combination with other fields, such as preventive medicine.” The study participants will continue to be monitored in future to help researchers learn more about the effects of exercise over the long term.