Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy最新文献

{"title":"Risk Factors for Bleeding and Thromboembolic Events in Patients With Chronic Kidney Disease on Maintenance Hemodialysis: A Retrospective Case-Control Study Based on the Roxadustat User Population.","authors":"Ruijie Man, Yufeng Li, Yue Zhang, Xiaochong Zhu, Hongdong Huang","doi":"10.1002/1744-9987.70139","DOIUrl":"10.1002/1744-9987.70139","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) often necessitates maintenance hemodialysis, a process associated with significant complications such as bleeding and thromboembolic events. Roxadustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor, is emerging as a promising alternative for managing anemia in CKD. This study aims to assess risk factors for bleeding and thromboembolic events in CKD patients on hemodialysis, focusing on Roxadustat use.</p><p><strong>Methods: </strong>We conducted a retrospective case-control study of 229 CKD patients undergoing maintenance hemodialysis for at least 1 year. Patients were categorized based on the occurrence of bleeding (n = 51) or thromboembolic events (n = 58), compared to those without such events (n = 120). Baseline demographics, laboratory markers, and Roxadustat usage were evaluated. Logistic regression analyses were used to identify independent risk factors for bleeding and thromboembolic events.</p><p><strong>Results: </strong>Roxadustat usage was significantly less common in patients who experienced bleeding events (64.71%) compared to the no occurrence group (85.00%, p = 0.003), and similarly less common in those with thromboembolic events (67.24%) compared to the no occurrence group (85.00%, p = 0.006). Lower baseline hemoglobin levels were associated with bleeding events (p = 0.007), while higher baseline hemoglobin levels were associated with thromboembolic events (p = 0.008). Elevated baseline hs-CRP levels were significant in both the bleeding group (p = 0.001) and thromboembolic group (p = 0.019). TSAT below 30% at baseline was also a significant factor in both the bleeding group (p = 0.004) and thromboembolic group (p = 0.025). Multivariate analyses indicated that Roxadustat use significantly reduced bleeding risk (OR = 0.376, p = 0.024) and thromboembolic events (OR = 0.287, p = 0.003).</p><p><strong>Conclusion: </strong>Roxadustat use was associated with a lower risk of bleeding and thromboembolic events in CKD patients on hemodialysis. This association may be mediated through the stabilization of hemoglobin levels, modulation of iron metabolism, and attenuation of inflammation.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"511-522"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Exchange as a Bridge to Recovery in Severe Pediatric Neurological Diseases in Pediatric Intensive Care.","authors":"Güntülü Şık, Gamze Başak, Tuğba Kanar, Servet Yüce, Serhat Güler, Hüseyin Kılıç, Sema Saltık","doi":"10.1002/1744-9987.70150","DOIUrl":"10.1002/1744-9987.70150","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic plasma exchange (TPE) removes circulating pathogenic antibodies, immune complexes, cytokines, and complement components. While established in adult neurology, evidence on its safety and efficacy in pediatric neurocritical care remains limited.</p><p><strong>Objective: </strong>To evaluate the indications, clinical efficacy, and safety of TPE in children with acute or subacute immune-mediated neurological disorders admitted to the pediatric intensive care unit (PICU).</p><p><strong>Methods: </strong>A retrospective cohort of 24 pediatric patients (aged 1-18 years) treated with TPE between February 2023 and October 2025 was analyzed. Diagnoses included multiple sclerosis (n = 8), Guillain-Barré syndrome (n = 5), acute disseminated encephalomyelitis (n = 3), transverse myelitis (n = 3), autoimmune encephalitis (n = 3), optic neuritis (n = 1), and myasthenia gravis (n = 1). Patients received 3-7 TPE sessions. Clinical response was measured using the modified Rankin Scale (mRS) and GBS disability scores before and after treatment.</p><p><strong>Results: </strong>A total of 130 sessions were performed. Clinical improvement occurred in 20 of 24 patients (83%)-moderate in 8 (33%) and mild in 12 (50%). Median mRS/GBS scores decreased from 4.0 to 3.0 (p = 0.001). Early initiation of TPE (≤ 7 days from symptom onset) was associated with a higher likelihood of neurological improvement in multivariable analysis. No life-threatening complications were observed. Transient, reversible events included hypocalcemia (2.3%), hypotension (1.5%), and urticaria (1.6%).</p><p><strong>Conclusion: </strong>TPE appears to be a safe and potentially beneficial intervention for severe or refractory pediatric neuroimmunological disorders. Earlier initiation of TPE was associated with improved neurological outcomes; however, these findings should be interpreted cautiously given the small sample size and heterogeneous disease groups. These findings support integrating TPE into multidisciplinary PICU management and add to the growing evidence supporting its use in pediatric neuroimmunology.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"560-568"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety Analysis of Roxarestat in Regulating Renal Anemia in Patients on Maintenance Hemodialysis.","authors":"Lingling Chen, Junjie Zhu, Qiaonan Ge","doi":"10.1002/1744-9987.70138","DOIUrl":"10.1002/1744-9987.70138","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of roxarestat versus recombinant human erythropoietin (rhEPO) in the management of renal anemia in patients undergoing maintenance hemodialysis.</p><p><strong>Methods: </strong>This was a prospective, open-label, randomized controlled trial. A total of 240 patients were randomly assigned to receive either oral roxarestat (n = 120) or subcutaneous rhEPO (n = 120) for 6 months. The target hemoglobin (Hb) range was set at 110-130 g/L for both groups, and dose adjustments were permitted based on Hb levels during follow-up. The primary endpoint was the change in Hb level from baseline to 6 months. Secondary endpoints included changes in red blood cell (RBC) count, hematocrit (Hct), iron metabolism parameters (serum ferritin [SF], serum iron [SI], hepcidin [Hepc], transferrin [TRF], total iron binding capacity [TIBC]), inflammatory markers (tumor necrosis factor-α [TNF-α], interleukin-1β [IL-1β], interleukin-6 [IL-6]), quality of life scores (Kidney Disease Quality of Life-36 [KDQOL-36]), and the incidence of adverse events.</p><p><strong>Results: </strong>After 6 months, Hb increased from 82.13 ± 27.43 g/L to 101.3 ± 10.34 g/L in the rhEPO group and from 83.60 ± 8.29 g/L to 110.6 ± 11.00 g/L in the roxarestat group. The increase in Hb was significantly greater in the roxarestat group (mean difference 9.30 g/L, 95% CI 6.45-12.15, p < 0.001). Similarly, RBC and Hct levels were also significantly higher in the roxarestat group compared with the rhEPO group (p < 0.05 for both). Improvements in iron metabolism parameters and reductions in inflammatory markers were more pronounced in the roxarestat group. Quality of life scores improved in both groups, with significantly higher scores in the roxarestat group in all KDQOL-36 subscales (p < 0.05). The incidence of adverse events was 20.83% in the roxarestat group and 16.67% in the rhEPO group, with no statistically significant difference (p = 0.226).</p><p><strong>Conclusion: </strong>Roxarestat was more effective than rhEPO in increasing hemoglobin levels and other anemia-related parameters in maintenance hemodialysis patients, with comparable safety. The findings suggest that roxarestat may offer advantages in iron metabolism modulation and inflammation reduction, contributing to improved quality of life.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"585-593"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Honoring the Past and Leading the Future (): A Report on the 46th Annual Meeting of the Japanese Society for Apheresis.","authors":"Takafumi Ito","doi":"10.1002/1744-9987.70167","DOIUrl":"10.1002/1744-9987.70167","url":null,"abstract":"","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"449-451"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of Checklist for Briefing in Apheresis Therapy and Its Efficacy.","authors":"Makiko Suzuki, Hajime Hirano, Takahiro Inoue, Yu Munakata, Yoshie Tokui, Ken Ito, Hiromi Horimoto, Takashi Kumamaru, Isao Tanaka, Kaori Yamazaki, Goki Matsumura, Yuko Shimizu, Osamu Segawa, Katsuji Nishimura, Norio Hanafusa","doi":"10.1002/1744-9987.70166","DOIUrl":"10.1002/1744-9987.70166","url":null,"abstract":"<p><strong>Purpose: </strong>A checklist is an effective tool for ensuring patient safety. We have already been using a briefing checklist for hemodialysis. However, we did not have ones for apheresis therapy. From the experiences of incidents that occurred in February and March 2024. We decided to create a briefing checklist for apheresis therapy, especially for plasma exchange (PE) and double filtration plasmapheresis (DFPP).</p><p><strong>Methods: </strong>First, we made a briefing checklist specific to apheresis therapies, different from hemodialysis. Another incident occurred 6 months later, revealing that staff used the checklist in a manner different from the intended one. The fact prompted us to revise the apheresis therapy checklist, with items and the order of appearance similar to those of the hemodialysis checklist. We also provided detailed explanations of apheresis therapy for clinical engineers unfamiliar with it. We have not experienced any incident since September 2024, when the revised procedures were implemented, until May 2025.</p><p><strong>Conclusion: </strong>The briefing checklist provided benefits, including improved patient safety and education for clinical engineers unfamiliar with apheresis. the revision process further improved the checklist's efficiency.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"471-475"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Nordic Walking in Improving Walking Ability in Patients on Peritoneal Dialysis: A Randomized Controlled Trial.","authors":"Rena Sumura Sonoda, Kiyotaka Uchiyama, Yuka Inaba, Chiaki Kasahara, Tomoki Sato, Ayaka Kaihara, Shohei Yamada, Shingo Urate, Mai Yanagi, Satoshi Kinugasa, Kiyokazu Tanaka, Junichi Kunoki, Yoshitaka Ishibashi","doi":"10.1002/1744-9987.70141","DOIUrl":"10.1002/1744-9987.70141","url":null,"abstract":"<p><strong>Background: </strong>Nordic walking (NW) is a four-point walking style that may improve exercise tolerance in chronic diseases, but its effects in peritoneal dialysis (PD) patients remain unclear.</p><p><strong>Methods: </strong>PD patients with sarcopenia and/or musculoskeletal pain were randomly assigned to NW or usual care. The intervention consisted of NW for 20-30 min/day, at least three times per week for 12 weeks. The primary endpoint was the change in 6-min walking distance (6MWD).</p><p><strong>Results: </strong>Twenty-four patients were enrolled (13 in the intervention group, 11 in the usual care group; age 74.0 ± 6.8 years; 6MWD 391.0 ± 58.1 m). Instructional compliance was 96% in the intervention group. The change in 6MWD was greater in the intervention group than in usual care (33.1 ± 33.5 vs. 4.9 ± 32.9 m), reaching borderline significance (p = 0.05).</p><p><strong>Conclusion: </strong>NW may be associated with improved walking ability in PD patients with sarcopenia or musculoskeletal pain, with a high adherence rate.</p><p><strong>Trial registration: </strong>UMIN-CTR no.: UMIN 000052466.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"502-510"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centrifugal Versus Membrane-Based Therapeutic Plasma Exchange in Pediatric Seronegative Neuroimmune Disorders: Neurologic Outcome and Age Specific Safety Profile.","authors":"Ebru Atike Ongun, Sultan Aydın, Hasan Serdar Kıhtır, Erdem Çebişli, Muhammed Gultekin Kutluk, Duygu Güner Özcanyüz, Ayse Oz, Volkan Karakuş","doi":"10.1002/1744-9987.70140","DOIUrl":"10.1002/1744-9987.70140","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the effectiveness of therapeutic plasma exchange (TPE) modalities in seronegative pediatric neuroimmune disorders, focusing on acute therapy response, 6-month neurological outcomes, and age-stratified adverse events.</p><p><strong>Methods: </strong>Retrospective observational cohort between 2018 and 2024. Neurological outcomes were assessed at five predetermined set points during 6 months.</p><p><strong>Results: </strong>Forty-six children underwent 304 TPE procedures in 49 sessions. Early favorable recovery were 84% for autoimmune-encephalitis, 75% for CNS-demyelinating-disorders, 83.3% for Guillan-Barre-syndrome, 66.7% of Juvenile-Myasthenia-Gravis cases. Six-months neurological outcome showed similar recovery rates irrespective-of-TPE-modality used (F[4169] = 0.53, p = 0.711; F[4470] = 0.69, p = 0.602 for CNS and PNS disorders). Adverse events occurred in 20.1% of TPE sessions, were largely age-dependent rather than disease-category or modality-driven, with a 0.891-fold reduction in the likelihood of AE occurrence for each-year increment (OR = 0.891, 95% CI: 0.825-0.962, p = 0.003).</p><p><strong>Conclusion: </strong>Centrifugal and membrane-based TPE are associated with good neurological recovery in seronegative pediatric neuroimmune disorders. Patient age, rather than apheresis modality or disease subtype, has emerged as the primary determinant of the adverse event profile.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"489-501"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Antioxidant Effects of Vitamin E-Coated Filters During Continuous Kidney Replacement Therapy in Critically Ill Patients.","authors":"Masahiro Kawamura, Masafumi Fukuda, Nobuhisa Hirayu, Masakazu Nabeta, Keisuke Yoshida, Osamu Yamaga, Kei Fukami, Osamu Takasu, Norio Yamashita","doi":"10.1002/1744-9987.70135","DOIUrl":"10.1002/1744-9987.70135","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the short-term antioxidant effects of a vitamin E-coated membrane during continuous kidney replacement therapy (CKRT) based on the neutrophil-to-lymphocyte ratio (NLR) and red cell distribution width (RDW).</p><p><strong>Methods: </strong>CKRT sessions conducted between December 2023 and May 2025 at a single tertiary-care center were retrospectively analyzed. Based on the type of hemofilter used, sessions were categorized into polysulfone membrane (PS) and vitamin E-coated membrane (VE) groups. Laboratory parameters at CKRT initiation and 48 h thereafter were compared between the two groups.</p><p><strong>Results: </strong>Overall, 79 CKRT sessions (33 patients) were analyzed. In the PS group, NLR and RDW-SD increased significantly (p < 0.01 and p = 0.03), whereas no significant changes were observed in the VE group.</p><p><strong>Conclusion: </strong>Vitamin E-coated membranes may exert short-term antioxidant effects during CKRT by reducing inflammatory and oxidative responses as reflected by NLR and RDW.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"530-535"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the Fluid Replacement Method During Online Hemodiafiltration on the Solute Removal Performance and Biocompatibility Using the Asymmetric Cellulose Triacetate Membrane.","authors":"Kenji Sakurai, Yoshitaka Kurihara, Fumi Yamauchi, Hiromi Hosoya, Takeshi Saito","doi":"10.1002/1744-9987.70147","DOIUrl":"10.1002/1744-9987.70147","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-dilution online hemodiafiltration (Pre-HDF) is predominantly used in Japan, whereas post-dilution online HDF (Post-HDF) is more common in Europe. An asymmetric cellulose triacetate (ATA) membrane may improve biocompatibility. This study compared biocompatibility and solute removal performance between Pre- and Post-HDF using the ATA membrane.</p><p><strong>Methods: </strong>Eight stable maintenance hemodialysis patients underwent both Pre- (60 L/session) and Post-HDF (12 L/session) using an ATA membrane. Blood flow rate was 250 mL/min, total dialysate flow rate was 500 mL/min, and treatment time was 4 h. Biocompatibility and solute removal parameters were evaluated.</p><p><strong>Results: </strong>White blood cell and platelet counts showed mild decreases; inflammatory markers remained unchanged in both modalities. CD62P expression increased more in Post-HDF. Reduction rates of urea, creatinine, and α1-microglobulin were higher in Post-HDF, while β2-microglobulin was comparable. Albumin leakage was greater in Post-HDF.</p><p><strong>Conclusions: </strong>Using the ATA membrane, Pre- and Post-HDF showed comparable biocompatibility, while Post-HDF provided superior solute removal performance.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"523-529"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Intradialytic Exercise on Functional Capacity and Health-Related Quality of Life in Hemodialysis Patients.","authors":"Ozal Keles, Z Candan Algun, Tugba Civi Karaaslan, N Ozlem Harmankaya Kaptanogullari, Hakan Kaptanogullari","doi":"10.1002/1744-9987.70153","DOIUrl":"10.1002/1744-9987.70153","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney failure often experience reduced physical function due to inactivity and arteriovenous fistula-related complications, negatively affecting quality of life. This study aimed to investigate the effect of intradialytic exercise on functional capacity, quality of life, fatigue, and depression in hemodialysis patients.</p><p><strong>Methods: </strong>This was a prospective, randomized controlled trial including 72 hemodialysis patients (aged 18-80 years) undergoing treatment three times per week for at least 1 year. Participants were randomly assigned to an exercise group (mean age: 55.7 ± 12.0 years) or a control group (mean age: 54.6 ± 14.2 years). The exercise group performed supervised combined aerobic and resistance exercises during dialysis sessions, three times weekly for 8 weeks, while the control group received routine hemodialysis care. Outcomes were assessed at baseline and after 8 weeks using the Six-Minute Walk Test, Five-Repetition Sit-to-Stand Test, Kidney Disease Quality of Life-36 questionnaire, Visual Analog Scale for fatigue, Beck Depression Inventory.</p><p><strong>Results: </strong>Fifty-nine patients completed the study (exercise group: n = 30; control group: n = 29). Both groups were similar at baseline. Post-intervention, the exercise group demonstrated significant improvements in physical performance (p = 0.046), quality of life subdomains (p < 0.05), and depression (p < 0.001), whereas no significant change was observed in functional capacity (p = 0.627) or fatigue (p = 0.537). In contrast, the control group demonstrated declines in several quality of life subdomains (p < 0.05), with significant worsening in fatigue (p = 0.011) and depression (p = 0.011).</p><p><strong>Conclusions: </strong>Intradialytic exercise is an effective intervention to improve physical and psychological outcomes in hemodialysis patients, suggesting its integration into routine dialysis care may help mitigate progressive functional decline.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05246956.</p>","PeriodicalId":94253,"journal":{"name":"Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy","volume":" ","pages":"602-612"},"PeriodicalIF":1.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147936721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}