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‘There is nothing more deceptive than an obvious fact’: more evidence for the prescription of exercise during haemodialysis (intradialytic exercise) is still required
  1. Daniel S March1,2,
  2. Matthew PM Graham-Brown2,3,
  3. Hannah ML Young1,2,
  4. Sharlene A Greenwood4,
  5. James O Burton1,2
  1. 1 Department of Infection Immunity and Inflammation, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
  2. 2 John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
  3. 3 National Centre for Sport and Exercise Medicine, and School of Sport, Exercise and Health Sciences, University of Loughborough, Loughborough, UK
  4. 4 Department of Physiotherapy and Renal Medicine, King's College London, London, UK
  1. Correspondence to Dr Daniel S March, Department of Infection, Immunity & Inflammation, University of Leicester, Leicester, Leicestershire, UK; dsm12{at}

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With regard to the recent editorial,1 we applaud the author’s call to arms for nephrologists to ‘prescribe’ exercise during haemodialysis (HD). It is true that exercise has tremendous health benefits, with many likely benefits for HD patients. Staying physically active is essential to maintaining health, and unquestionably clinicians caring for HD patients should be counselling patients to increase physical activity levels. There are, however, unresolved questions that must be answered before structured programmes of intradialytic exercise (IDE) can simply be ‘prescribed’ by clinicians, as Deschamps suggests. The UK Renal Association clinical practice guidelines for cardiovascular disease state that exercise should be encouraged for all HD patients,2 but practical recommendations on prescribing and dosing of exercise (and indeed safest modes of exercise) cannot currently be made based on the available evidence. …

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  • Contributors DSM developed the idea for the response.

    DSM and MPMG-B composed the letter.

    DSM, MPMG-B, HMLY, SG and JB revised the letter.

  • Competing interests None declared.

  • Patient consent Not commissioned; externally peer reviewed.