Background: Physical inactivity in end-stage kidney disease (ESKD) patients is linked to poor quality of life, lower physical function, and higher morbidity. Promoting physical activity and improving performance is vital for their care. This post-hoc analysis of the EXerCise Introduction to Enhance Performance in Dialysis (EXCITE) trial examined the effects of a six-month exercise program for dialysis patients stratified by sex. Methods: In the EXCITE trial participants were randomized into an exercise versus a control group. Eligible patients were recruited from 13 centers over 11/2009-2/2011 and were followed for 36 months. This analysis focused on sex-stratified effects, including 227 dialysis patients (151 males, 76 females) who completed the six-minute walking distance test (6MWD) and the five times sit-to-stand test (5STS) at baseline and after six months. The primary outcomes were changes in 6MWD and 5STS over a six-month period. Data were analyzed using linear regression models to assess sex as an effect modifier. Results: Both male [+37.1 meters versus +12.6 meters, p=0.005] and female [+ 42.7 meters versus -18.5 meters, p<0.001] patients in the exercise group showed significant improvements in 6MWD compared to controls. In unadjusted (P=0.02) and fully adjusted (p=0.006) interaction analyses, the response to this test in females improved more than in males. In sex-stratified analyses, the between groups difference in the response to the 5STS was numerically larger in females [-2.5 seconds versus +0.4 seconds, p=0.007] than in males [-2.4 seconds versus -1.2 seconds, p=0.06], but this difference did not reach statistical significance in interaction analysis (unadjusted, p=0.15; fully adjusted, p=0.11) . Conclusions: The exercise program improved physical performance in dialysis patients, with females showing more significant enhancements in 6MWD. These exploratory findings suggest sex-specific physiological differences may influence exercise outcomes in dialysis patients.
Sex Differences in the Exercise Introduction to Enhance Performance in Dialysis (EXCITE) Trial
Mallamaci F.;D'Arrigo G.;Tripepi G.;Torino C.;Zoccali C.
2025
Abstract
Background: Physical inactivity in end-stage kidney disease (ESKD) patients is linked to poor quality of life, lower physical function, and higher morbidity. Promoting physical activity and improving performance is vital for their care. This post-hoc analysis of the EXerCise Introduction to Enhance Performance in Dialysis (EXCITE) trial examined the effects of a six-month exercise program for dialysis patients stratified by sex. Methods: In the EXCITE trial participants were randomized into an exercise versus a control group. Eligible patients were recruited from 13 centers over 11/2009-2/2011 and were followed for 36 months. This analysis focused on sex-stratified effects, including 227 dialysis patients (151 males, 76 females) who completed the six-minute walking distance test (6MWD) and the five times sit-to-stand test (5STS) at baseline and after six months. The primary outcomes were changes in 6MWD and 5STS over a six-month period. Data were analyzed using linear regression models to assess sex as an effect modifier. Results: Both male [+37.1 meters versus +12.6 meters, p=0.005] and female [+ 42.7 meters versus -18.5 meters, p<0.001] patients in the exercise group showed significant improvements in 6MWD compared to controls. In unadjusted (P=0.02) and fully adjusted (p=0.006) interaction analyses, the response to this test in females improved more than in males. In sex-stratified analyses, the between groups difference in the response to the 5STS was numerically larger in females [-2.5 seconds versus +0.4 seconds, p=0.007] than in males [-2.4 seconds versus -1.2 seconds, p=0.06], but this difference did not reach statistical significance in interaction analysis (unadjusted, p=0.15; fully adjusted, p=0.11) . Conclusions: The exercise program improved physical performance in dialysis patients, with females showing more significant enhancements in 6MWD. These exploratory findings suggest sex-specific physiological differences may influence exercise outcomes in dialysis patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
