Article PDF first page preview

First page of Intradialytic Cognitive and Aerobic Exercise Training to Preserve Cognitive Function: IMPCT, A Multi-Dialysis Center 2x2 Factorial Block-Randomized Controlled Trial

Introduction: Patients with end-stage kidney disease (ESKD) develop cognitive impairment due to comorbidities and dialysis dependence. Among community-dwelling older adults, cognitive (CT) and exercise training (ET) are promising interventions to preserve cognition; these interventions may be tailored for adults undergoing in-center hemodialysis. Methods: Adult (≥18 years) English-speaking patients undergoing hemodialysis (within 3 months to 3 years of initiation) were enrolled in a 2x2 factorial randomized controlled trial: Interventions Made to Preserve Cognitive Function Trial (IMPCT). Participants (n=121) were block-randomized (09/2018-02/2023) into 4 arms: control (SC) (n=26), intradialytic web-based CT (n=31), ET using foot peddler (n=29), and combined CT+ET (n=35). Participants underwent assessments at baseline and 3 months for executive function, global cognitive function, clinical outcomes, and patient-centered outcomes. We estimated 3-month executive function change (primary outcome) and secondary outcomes using linear regression. Results: There were no differences in 3-month executive function change by arm. Participants exhibited improvement in 3-month global cognitive function in CT+ET arm (Montreal Cognitive Assessment score difference=2.1, 95%CI:0.4-3.9), and self-reported 3-month improvement in perceived health change (score difference=0.8, 95%CI:0.2-1.4) in ET arm. Conclusion: Clinicians may encourage CT+ET for hemodialysis patients to improve short-term global cognitive function and perceived health. The long-term benefits of these interventions warrant further study. This trial was registered at clinicaltrials.gov (NCT03616535). URL: https://clinicaltrials.gov/study/NCT03616535.

Journal Section:
Transplantation
This content is only available via PDF.
The Author(s). Published by S. Karger AG, Basel
Open Access License / Drug Dosage / Disclaimer
This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2025
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License .
Attribution-NonCommercial