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Randomized Controlled Trial
. 2016 Jul 8;17(1):69.
doi: 10.1186/s12882-016-0294-7.

Design and methods of CYCLE-HD: improving cardiovascular health in patients with end stage renal disease using a structured programme of exercise: a randomised control trial

M P M Graham-Brown  1   2   3 , D S March  4   5 , D R Churchward  4   5 , H M L Young  4   5 , M Dungey  4   5 , S Lloyd  6 , N J Brunskill  4   5 , A C Smith  4   5 , G P McCann  4   7 , J O Burton  4   5   7
Affiliations
Randomized Controlled Trial

Design and methods of CYCLE-HD: improving cardiovascular health in patients with end stage renal disease using a structured programme of exercise: a randomised control trial

M P M Graham-Brown et al. BMC Nephrol. .

Abstract

Background: There is emerging evidence that exercise training could positively impact several of the cardiovascular risk factors associated with sudden cardiac death amongst patients on haemodialysis. The primary aim of this study is to evaluate the effect of an intradialytic exercise programme on left ventricular mass.

Method and design: Prospective, randomised cluster open-label blinded endpoint clinical trial in 130 patients with end stage renal disease on haemodialysis. Patients will be randomised 1:1 to either 1) minimum of 30 min continuous cycling thrice weekly during dialysis or 2) standard care. The primary outcome is change in left ventricular mass at 6 months, assessed by cardiac MRI (CMR). In order to detect a difference in LV mass of 15 g between groups at 80 % power, a sample size of 65 patients per group is required. Secondary outcome measures include abnormalities of cardiac rhythm, left ventricular volumes and ejection fraction, physical function measures, anthropometric measures, quality of life and markers of inflammation, with interim assessment for some measures at 3 months.

Discussion: This study will test the hypothesis that an intradialytic programme of exercise leads to a regression in left ventricular mass, an important non-traditional cardiovascular risk factor in end stage renal disease. For the first time this will be assessed using CMR. We will also evaluate the efficacy, feasibility and safety of an intradialytic exercise programme using a number of secondary end-points. We anticipate that a positive outcome will lead to both an increased patient uptake into established intradialytic programmes and the development of new programmes nationally and internationally.

Trial registration number: ISRCTN11299707 (registration date 5(th) March 2015).

Keywords: Cardiovascular disease; Haemodialysis; Intra-dialytic cycling; Intra-dialytic exercise; Sudden cardiac death.

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Figures

Fig. 1
Fig. 1
CYCLE HD study protocol timeline
Fig. 2
Fig. 2
Cardiac MRI Protocol. (4/3/2C, 4/3/2 Chamber; LV, Left Ventricular; SA, Short Axis)
Fig. 3
Fig. 3
Patient undertaking intradialytic cycling on specially adapted cycle
See this image and copyright information in PMC

References

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    1. U.S. Renal Data System . USRDS 2006 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. 2006.
    1. Herzog CA. Cardiac arrest in dialysis patients: approaches to alter an abysmal outcome. Kidney Int. 2003;63:S197–S200. doi: 10.1046/j.1523-1755.63.s84.17.x. - DOI - PubMed

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