Impact of Intradialytic Exercise on Infection Rate and Calcium–Phosphate Product in Pediatric Hemodialysis Patients: A Pilot Study
Journal of Pediatric Nephrology,
Vol. 13 No. 1 (2025),
12 May 2026
https://doi.org/10.22037/jpn.v13i1.51236
Abstract
Background and Aim:
Children with chronic kidney disease (CKD) undergoing maintenance hemodialysis (HD) are highly susceptible to infections and disturbances in mineral metabolism, including elevated calcium–phosphate (Ca×P) product. Intradialytic exercise has been proposed as a safe non-pharmacologic intervention, but evidence in pediatric HD populations is limited. This pilot study aimed to evaluate the feasibility of an eight-week combined intradialytic exercise program and its effects on infection rate and Ca×P product in children receiving HD.
Methods:
This quasi-experimental single-group pre–post pilot study included children aged 8–18 years undergoing maintenance HD. Participants performed supervised combined resistance and aerobic exercise during HD sessions three times per week for eight weeks. Infection events were recorded using standardized clinical and laboratory criteria. Serum calcium and phosphate were measured before and after the intervention, and Ca×P product was calculated. Pre- and post-intervention values were compared using paired statistical analyses, and infection rates during exercise and non-exercise periods were compared.
Results:
Nine children initiated the program and five completed the intervention. Mean Ca×P increased from 52.70 ± 17.71 to 59.43 ± 8.43 mg²/dL², with no statistically significant difference (p = 0.36). Mean infection rate was 10% during exercise months and 16% during non-exercise months, with no significant difference between periods (p = 0.673). The exercise protocol was implemented safely and without major adverse events.
Conclusion:
An eight-week combined intradialytic exercise program was feasible and safe in pediatric HD patients, but did not significantly affect infection rate or Ca×P product in this small pilot study. Larger controlled trials are required to clarify the potential clinical benefits of intradialytic exercise in this population.
- Chronic Kidney Disease
- Muscle strength
- Resistance training
- Aerobic training
How to Cite
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