Ken Wilund, PhD; University of Illinois, Urbana-Champaign, IL
Individuals with kidney failure undergoing maintenance hemodialysis (HD) have a plethora of comorbidities that adversely impact their health and quality of life (QOL). Muscle wasting, bone disorders, and cardiovascular complications are especially common. In addition, nearly two-thirds of HD patients die within 5 years of starting long-term dialysis treatment. Research suggests that HD patient’s health and QOL may improve by increasing their physical activity levels, so many have argued that exercise programs should be included as a part of their standard of care. Despite this, exercise programs are rarely implemented in HD clinics, in part because there is still some skepticism over their value, and there are no sustainable funding sources to pay for them. Moreover, participation rates in the programs that do exist are low, dropout rates are high, and physical inactivity and dysfunction remain hallmarks of the disease. Indeed, standard approaches to exercise in HD patients often fail to produce expected benefits, and novel approaches are needed to produce robust improvements in their health and QOL, as well as to reduce the cost of their care. We suggest novel research approaches for increasing physical activity levels in this population. This will include moving toward using more personalized approaches that include physical activity as a component of a comprehensive behavior change intervention strategy.
ABOUT THE PRESENTER
- Critically evaluate the literature regarding the efficacy of exercise for improving physical function and cardiovascular disease risk in dialysis patients
- Describe strengths and limitations of exercise protocols typically prescribed for dialysis patients
- Examine the potential efficacy of novel intervention strategies designed to increase patient participation in exercise and physical activity programs
Dr. Ken Wilund is a Professor in the Department of Kinesiology and Community Health at the University of Illinois at Urbana-Champaign. His research is focused on examining the effects of exercise training and nutritional factors on cardiovascular health and muscle wasting in in patients with kidney failure. He has a particular interest in the role that dietary sodium has on both chronic fluid overload, a condition that contributes to heart failure, as well as muscle sodium accumulation, which may contribute to deficits in muscle strength and function. His long-term goals include developing strategies that shift the focus of the care of dialysis patients from predominantly pharmacological approaches to strategies that rely on lifestyle management, such as improved nutrition and physical activity. He is also the founder and a current Co-Chair of the Global Renal Exercise (GREX) Network, an international group of clinicians and researchers whose goal is to improve research and the implementation of physical activity programs in people with kidney disease.