A pilot study to determine the impact of exercise on cognitive function in haemodialysis patients

Principal Investigator – Dr J Tollitt

Like most of the UK population, patients with kidney disease exercise less frequently than is recommended. Exercise is known to benefit our health, mobility and well-being. Dialysis is a treatment which replaces some of the functions of the kidney in patients with severe kidney disease. Most dialysis patients dialyse for 4 hours 3 times per week in order to remove enough toxins and fluid from their blood. Patients on dialysis therefore, find it particularly difficult to commit to exercise programmes because of this time spent on dialysis. Exercise is one of the key treatments to combat heart disease, stroke and dementia. Patients on dialysis are very likely to suffer from these conditions as well as their kidney disease. It is therefore important that exercise initiatives and treatments are focussed on these patients who need it most.

Cognitive impairment describes reduced function of the brain, which is beyond that of normal ageing. In contrast to dementia, the subtle effect of cognitive impairment on activities of daily life while experienced by the individual and their families, remains undetected by others. The severity of impairment is linked to severity of changes seen on magnetic resonance scans of the brain.

This study will assess a variety of brain functions in a group of 20 patients randomised into to start a 9-month exercise programme on dialysis or standard care. It will then repeat the tests at the end of the programme. 10 of the patients will also be asked to attend for 2 non-radiation brain scans at the start and at the end of the study. The results of this study will then be used to determine the practicalities to perform a much bigger study and therefore answer the question “Does exercise on dialysis reduce the risk of brain impairment and dementia.”