Intradialytic Cognitive and Aerobic Exercise Training to Preserve Cognitive Function: IMPCT, a Multi-Dialysis Center 2 × 2 Factorial Block-Randomized Controlled Trial

作者：N. Ghildayal, Yi Liu, Jingyao Hong, Yiting Li, Xiaomeng Chen, M. G. Fernández, Michelle C Carlson, Derek M. Fine, Lawrence J. Appel, M. Diener-West, D. Charytan, A. Mathur, D. Segev, M. McAdams‐DeMarco · 发表于：American Journal of Nephrology · 年份：2025 · DOI：10.1159/000546296 · 研究领域：Medicine

Abstract Introduction: Patients with end-stage kidney disease 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 2 × 2 factorial randomized controlled trial: Interventions Made to Preserve Cognitive Function Trial (IMPCT). Participants (n = 121) were block-randomized (September, 2018-February, 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 hemodialysi...