Strong Point of Inspiratory Muscle Training for Kidney and Immune Functions, and Quality of Life of Chronic Kidney Disease Patients on Hemodialysis
Phase: NA
Conditions: Chronic Kidney Disease Stage 5 on Dialysis
Sponsor: Universitas Padjadjaran

Strong Point of Inspiratory Muscle Training for Kidney and Immune Functions, and 
Quality of Life of Chronic Kidney Disease Patients on Hemodialysis 
 
NCT05241652 
 
May 1st, 2022 
 
 
Study Protocol 
This study included patients diagnosed with end-stage CKD who received HD twice a week 
for more than three months in the Hemodialysis Service. The inclusion criteria were: age 45–54 
years, can perform respiratory muscle training (RMT) procedures, have a MIP (Maximal 
Inspiratory Pressure) value of less than 70% of the predicted measurement results using the micro 
respiratory pressure meter (RPM) tool, hemoglobin level greater than 8 g/dL, ability to understand 
oral and written instructions, cooperative and willing to participate in the research, and able to do 
exercises after signing an informed consent form. The RMT used is Inspiratory muscle training 
(IMT). The exclusion criteria were: patients with obstructive lung disease, pleural effusion, 
cardiomegaly, heart failure, coronary heart disease, history of pneumothorax, history of thoracic 
or abdominal surgery in the last six months, disturbances related to eardrum damage, have received 
inspiratory and expiratory muscle training in the past six months, and blood pressure >180/110 
mmHg or <80/60 mmHg. Subjects are divided into two groups: control and intervention. 
We examined the levels of urea, creatinine, and IL-6 (prior to HD) and performed an 
interview using the KDQOL-SFTM v1.3 questionnaire before the IMT exercise program is 
conducted. For 12 weeks, the intervention group was assigned an IMT exercise program that 
included inspiratory muscle strengthening exercises thrice a week at a 50% MIP intensity, five sets 
per time, ten breathing repetitions per set, for an estimated duration of 20 minutes each using 
Threshold IMT. The control group received IMT exercise with an intensity of 10% MIP for 12 
weeks. 
A re-examination of the urea, creatinine, IL-6 levels, and re-administration of the KDQOL 
HD-SFTM v1.3 questionnaire was performed at the end of the IMT exercise program (after 12 
weeks). 
Serum urea and creatinine levels were used to measure kidney function. IL-6 levels were 
used to measure immune function. Inspiratory muscle training included specific exercises to 
improve ventilation through coordination, endurance, and respiratory strength of the inspiratory 
muscles. IMT measurements were performed using the Threshold IMT tool. Measurement of MIP 
was conducted  using Micro RPM prior to inspiratory muscle strengthening exercise. 
The KDQOL-SFTM v1.3 questionnaire was used to assess quality of life. This questionnaire 
consists of a physical component summary (PCS), mental component summary (MCS), and 
kidney disease component summary (KDCS).