الفهرس 
Mineral bone disorderOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease – mineral and bone disorder (CKD-MBD) is a systemic disorder manifested by one or more of the following: abnormalities in serum calcium, phosphorous, parathyroid hormone (PTH), or vitamin D, and also bone histological lesions marked by changes in bone turnover, mineralization, volume, growth and the presence of extraosseous vascular or other soft tissue calcification (Xiong, 2020).
The Kidney Disease Improving Global Outcome (KDIGO) recommended the measurement of serum PTH or bone specific alkaline phosphatase (BALP) to evaluate bone disease and monitor bone turnover in CKD (Fidan, et al 2016).
Biochemical markers of bone metabolism that reflect the cellular activity related to the formation and resorption of bone are useful in monitoring physical activity, and can help us understand the effects of exercise on bone (Maïmoun and Sultan 2011).
Not only does exercise preserve bone mass by stimulating bone formation and reducing bone resorption but also helps prevent falls by insuring Coordination, self-assurance, and appropriate muscular strength (Chodzko, et al. 2009).
The aim of this study is to evaluate the effect of intradialytic exercise training on bone markers in prevalent hemodialysis (HD) patients. The study was done on 40 patients with end stage renal disease on regular HD recruited from hemodialysis unit at Ain Shams University Hospital. Patients were equally divided into exercise group who participated in exercise program and control group matched for age, sex and BMI acted as controls and did not participate in exercise in any form.
All patients were subjected to Physical performance assessment using short physical performance battery tests SPBT and laboratory tests included; serum calcium, phosphorus, parathyroid hormone PTH, total serum alkaline phosphatase ALP and bone specific alkaline phosphatase BALP performed at baseline and after 3 months.
At baseline there was no difference between both groups regarding age, sex, physical performance and laboratory studies performed (P>0.05). There was significant increase in physical performance associated with decrease in serum PTH and increase in BALP and ALP in exercise group. However, in controls there was no significant change in SPBT scores, PTH, ALP and BALP after 3 months.
In Conclusion, intradialytic cycling exercise program resulted in significant increase in physical performance associated with decrease in serum PTH and increase in BALP and ALP in HD patients. This indicates the positive influence of exercise not only on physical performance in dialysis patients but also on bone metabolism.
CONCLUSIONS
Intradialytic cycling exercise program resulted in significant increase in physical performance associated with decrease in serum PTH and increase in BALP and ALP in HD patients. This indicates the positive influence of exercise not only on physical performance in dialysis patients but also on bone metabolism.