The kidney function of around 80,000 people in Germany is so severely restricted that they have to undergo dialysis several times a week. Those affected often suffer from additional health problems such as diabetes and heart disease - accordingly, sports activity is hardly possible for most patients. The large-scale study of a consortium under the scientific leadership of Prof. Dr. Martin Halle, head of the Chair of Preventive and Rehabilitative Sports Medicine, tackled this problem. 

The project was funded by the Innovation fund of the health insurance companies with around 5.2 million euros and published under the title "Exercise during Hemodialysis in Patients with Chronic Kidney Failure" in the renowned "New England Journal of Medicine Evidence" (NEJM Evid). 

Almost 1,000 patients in 21 German dialysis centres took part in the study.  "We have thus set up one of the world's largest studies on sports activity in patients with the disease," explains Martin Halle and adds: "The high number of participating patients - almost 60 percent of all dialysis patients - shows that they are also open to carrying out such training. A comparison with data from health insurance companies showed that the composition of the participants was representative for dialysis patients in Germany with regard to aspects such as age, gender and health status.

The participating patients received physical training over a period of twelve months, at least once and at most three times a week, while the control group received only medical care. The training included 30 minutes of endurance exercises with an ergometer and another 30 minutes of exercises with weights, elastic bands or balls - adapted to the individual possibilities of the patients.

The health status and thus also the living conditions of the participants had improved considerably after one year. Simple tests, such as standing up from a sitting position or covering six-minute distances, confirm the results: "We want the patients to be able to look after themselves at home and not have to go to old people's homes. Our tests showed that the quality of life has increased. For example, the patients were able to go to the bakery or visit friends independently," Prof. Halle is pleased to report.

Another sign of the positive effects of the training: the number of days that participants spent in hospital within the study period was only half as high with regular training as in the control group - on average two days instead of five.

"For me, the results speak a clear language," says Martin Halle. "With comparatively little effort, we can improve the health of those affected and also reduce costs for the healthcare system." According to the researchers' calculations, the cost of individualized training would be around 25 euros per training unit and person, whereas a daily hospital stay would cost almost 1,000 euros.

The DiaTT (Dialysis Training Therapy) consortium has submitted the final report on the study, which was financed by the innovation fund of the health insurance funds, to the Joint Federal Committee of the health insurance funds. This committee will finally decide whether training during dialysis will become an offer for all insured persons. "I hope that our training program will become a health insurance benefit," says Martin Halle. "Our study shows how important a holistic view of health is, especially for old and frail patients. High-tech medicine is important, but it can only reach its full potential in combination with other fields such as preventive medicine." In the coming years, the study participants will continue to be monitored in order to learn more about the effects of long-term training.

Halle also sees such projects as an important connecting point for future projects for the Department of Sport and Health Sciences in cooperation with medicine: "When sport, health and medicine come together - and above all work together - then something new can develop, as our study example shows. We should use these interfaces to develop new strategies in the long term," explains the medical director of the Chair of Preventive and Rehabilitative Sports Medicine. 

To the homepage of the Chair of Preventive and Rehabilitative Sports Medicine

To the study "Exercise during Hemodialysis in Patients with Chronic Kidney Failure"

Contact:

Prof. Dr. Martin Halle
Chair of Preventive and Rehabilitative Sports Medicine
Georg-Brauchle Ring 56
80992 München

phone: 089 4140 6774 (Klinikum rechts der Isar)
phone: 089 289 24441 (Uptown Campus)
e-mail: Martin.Halle(at)mri.tum.de
 

Text: CCC/Paul Hellmich/Bastian Daneyko
Photos: New England Journal of Medicine Evidence//private