Abstract: Objective  To investigate the effects of exercise rehabilitation on dialysis adequacy, nutrition, and lipid metabolism in maintenance hemodialysis (MHD) patients.  Methods  A total of 87 patients with inadequate dialysis from the Blood Purification Center of Nantong Second People's Hospital were selected. They were randomly divided into two groups: a control group receiving conventional treatment (including medication and hemodialysis) and an exercise group receiving conventional treatment plus aerobic and resistance exercises. The urea clearance index (Kt/V), nutritional markers, and lipid metabolism markers were compared between the two groups before the intervention, at 12 weeks (12W), and at 24 weeks (24W).  Results After 12 weeks and 24 weeks of intervention, the exercise group showed significantly higher Kt/V (t =-4.282,  -6.535; both P ＜0.001) and serum albumin (Alb) levels (t =-3.603, -5.333; P = 0.001, ＜0.001) compared to the control group. While the exercise group had significantly lower total cholesterol (TC) (t = 4.035, 3.918; both P＜ 0.001) and low-density lipoprotein (LDL) levels (t =2.258, 4.483; P =0.027, ＜0.001) than the control group. At 24 weeks of intervention, C-reactive protein (CRP) in the exercise group was significantly lower than that in the control group (intergroup Z=-4.349, P＜0.001). Compared to pre-intervention levels, the exercise group demonstrated significantly increased high-density lipoprotein (HDL) levels at both 12W and 24W (t =-2.425, -2.085; P=0.020, 0.043).  Conclusion  Aerobic and resistance exercise significantly improves dialysis adequacy, nutritional status, and lipid metabolism in MHD patients.

Key words: Maintenance hemodialysis; , Aerobic exercise, Resistance exercise; , Dialysis adequacy