<p>Sociodemographic characteristics at baseline.</p>

Background Chronic kidney disease poses a growing global health concern and is linked to several complications with higher prevalence and intensity in the hemodialysis (HD) population. These complications contribute to high morbidity and mortality and are associated with poor physical function, and poor quality of life. Intradialytic exercise has emerged as a promising strategy to improve HD patients’ clinically relevant outcomes. Aims Assess the effect of intradialytic exercise on the functional and metabolic status of patients undergoing HD, and on their physical performance and evaluate its safety and feasibility. Methods This was a pre-experimental clinical trial conducted between February and August 2024, including adult patients on maintenance HD at Sahloul University Hospital. Patients underwent a supervised intradialytic resistance training twice or three times a week, over a period of 12 weeks.. Dialysis adequacy parameters, physical function, cardiovascular parameters, as well as patients’ nutritional status were assessed before and after the intervention. Results Our study included 21 patient with a female predominance (76.2%). The population’s mean age was 44.5 ± 10.4 years. A total of five patients (23.8%) received hemodialysis twice a week, while the remaining 16 patients underwent dialysis three times a week. Over the three-month intervention, the six minutes walk test distance improved significantly with a mean paired difference of 26.4 m (p = 0.007). As for cardiovascular parameters we noted that intradialytic blood pressure decreased from 121.7 mmHg to 112 mmHg (p = 0.03). Dialysis adequacy markers also showed significant increases in creatinine reduction ratio (p = 0.04) and Urea Reduction Ratio (p = 0.04). Furthermore nutritional status showed fewer patients at risk of malnutrition and BMI shifted toward healthier ranges. Conclusion Our study results suggest that three months of intradialytic resistance exercise safely improved HD patients’ care including cardiovascular state, physical function and adequacy parameters. Further research especially combining resistance and aerobic exercise is needed to expand and generalize these results. Trial registration The trial was retrospectively registered with the Pan African Clinical Trial Registry (PACTR202506776186443).背景 慢性肾脏病（Chronic kidney disease）已成为日益严峻的全球性健康问题，其引发的多种并发症在血液透析（hemodialysis, HD）人群中患病率更高、病情更为显著。此类并发症会导致较高的发病率与死亡率，同时与患者躯体功能减退、生活质量下降密切相关。透析中运动（intradialytic exercise）现已成为改善HD患者临床相关结局的极具潜力的干预策略。 研究目的 本研究旨在评估透析中运动对HD患者躯体功能与代谢状态、以及身体活动能力的影响，并评价该干预措施的安全性与可行性。 研究方法 本研究为一项预实验性临床试验，于2024年2月至8月间开展，纳入萨赫卢勒大学医院的维持性HD成年患者。受试者在12周周期内，每周接受2次或3次监督下的透析中抗阻训练（intradialytic resistance training）。于干预前后分别评估透析充分性指标、躯体功能、心血管指标以及患者营养状态。 研究结果 本研究共纳入21例患者，女性占比76.2%。受试者平均年龄为44.5±10.4岁。其中5例患者（23.8%）每周接受2次HD治疗，其余16例患者每周接受3次HD治疗。在为期3个月的干预后，6分钟步行试验距离显著提升，配对均值差为26.4m（p=0.007）。心血管指标方面，透析中血压从121.7mmHg降至112mmHg（p=0.03）。透析充分性指标同样显示，肌酐减少率（creatinine reduction ratio）与尿素减少率（Urea Reduction Ratio）均显著升高（p均=0.04）。此外，营养状态方面，存在营养不良风险的患者数量减少，体重指数（BMI）向健康范围偏移。 结论 本研究结果表明，为期3个月的透析中抗阻训练可安全改善HD患者的健康结局，包括心血管状态、躯体功能与透析充分性指标。未来需开展更多研究（尤其是联合抗阻与有氧运动的研究）以拓展并推广本研究结果。 试验注册 本试验已在泛非洲临床试验注册中心（Pan African Clinical Trial Registry, PACTR202506776186443）完成回顾性注册。