Effect of Intradialytic Aerobic Exercise on Blood Pressure, MDA Levels, and SOD in Diabetic Kidney Disease Patients Undergoing Hemodialysis

Marcellino Mettafortuna Sephberlian, Agung Susanto, Arifin Arifin, Eti Poncorini Pamungkasari

Abstract

Introduction: Diabetic nephropathy (DKD) is a chronic kidney disease associated with diabetes mellitus patients. Hyperglycemia conditions trigger disruption of homeostasis between anti-oxidants and oxidants. An increase in free radicals triggers the body to produce superoxide dismutase (SOD). The increase in oxidants causes SOD to be unable to neutralize them optimally, thereby increasing oxidative stress. Oxidative stress can be assessed by measuring malondialdehyde (MDA). Various studies have been conducted involving intradialysis to determine whether physical exercise can reduce oxidant markers in diabetic nephropathy patients. This study aimed to determine the effect of intradialysis cycling for three months on blood pressure, MDA levels, and SOD in diabetic nephropathy patients undergoing hemodialysis (HD).

Methods: Experimental Study with a randomized controlled trial of all DKD in HD patients who met the inclusion and exclusion criteria. Patients were randomized into control and treatment groups. The treatment group was given aerobic cycling and intradialytic physical exercise in the HD room of RSUD Dr Moewardi, Surakarta, for 12 weeks. Aerobic physical exercise using a static bicycle (Adirmed Pedal Exercise Bike 931PE) is performed in the first 2 hours of the HD procedure. Physical exercise is performed in the first 2 hours of the HD procedure. Physical exercise lasts 15–30 minutes twice a week for 12 weeks. Statistical tests use a dependent t-test and Mann Whitney with ⍺ = 95% and significant p <0.05.

Results: Systolic and diastolic blood pressures were normally distributed, and then an independent t-test was performed with p > 0.05. Then the MDA and SOD levels were not normally distributed with the Wilcoxon test results for MDA levels (p< 0.05) and SOD levels (p> 0.05).

Conclusion: Intradialytic physical exercise does not affect systolic and diastolic blood pressure, can increase MDA levels statistically significant, and can increase SOD levels but not statistically significant.

Keywords

diabetic kidney disease; intradialytic; MDA; physical exercise; SOD.

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DOI: https://doi.org/10.20961/tscm.v1i2.80113

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