Please select the eligibility criteria that correspond to the clinical trial below.
Title: Intradialytic Pedalling Exercise and Vascular Hemodynamic Parameters Among Prevalent Hemodialysis Population
Brief Summary: The purpose of this pilot study is to evaluate 1) the effect of intradialytic pedaling exercise on arterial stiffness and other arterial hemodynamic parameters over 4 months, and 2) the longer-term effect of pedaling on arterial stiffness and other arterial hemodynamic parameters 4 months after finishing the exercise intervention (8 months after study initiation).

The investigators also aim to examine the impact of intradialytic pedaling exercise on general health, anthropometric measures, physical function, and routine laboratory blood markers as secondary outcome measures, as well as to assess feasibility, safety and adverse events associated with the intradialytic pedalling exercise.

Recruitment of more participants in the future will be considered if warranted.


Options:
A: Inclusion Criteria:

* on hemodialysis for ≥ 3 months
* able to walk
* able to give informed consent and willing to participate

Exclusion Criteria:

* unable to walk
* unable to understand directions or give informed consent
B: Inclusion Criteria:

* on HD for at least 6 months
* in sinus rhythm
* able to reach a sufficient workload during ergometry

Exclusion Criteria:

* with bundle branch block
* unstable hypertension
* diabetes mellitus
* severe congestive heart failure
* recent myocardial infarction
* unstable angina
C: Inclusion Criteria:

* Adult patients male or female (Age \> 21 years)
* Minimum dialysis vintage of 6 months
* Stable on hemodialysis
* Minimum Hemoglobin level of 10 g/dL
* Blood access capable of delivering the blood flow rate greater than 250 mL/min
* Preserved left ventricular ejection fraction (\>50%) on prior imaging study
* Able to complete a 6min-walk-test without abnormal physiological response, excessive fatigue, or musculoskeletal discomfort

Exclusion Criteria:

* History of recurring or persistent hypotension in past 3 months
* Pregnant woman
* Severely Hypertensive patients (SBP \> 180 mmHg and/or DBP \> 115 mmHg)
* History of recent myocardial infarction or unstable angina (within past 6 months)
* Significant valvular disease, i.e. severe aortic stenosis and moderate-severe mitral regurgitation.
* Patients with end stage organ disease e.g. COPD, recent or debilitating CVA
* Patient with recent stroke (within past 6 months)
* Anemic patients
* History of known arrhythmia
* Participation in another clinical intervention trial
* Moderate to severe osteoarthritis of knee(s)
* Unable to consent
D: Inclusion Criteria:

* Adults with end-stage renal disease (stage 5 CKD), who were on a stable in-center hemodialysis regimen (approximately 4 hours 3 times per week) for ≥ 12 weeks prior to recruitment
* A cardiac evaluation was required within the last year to ensure adequate cardiac function

Exclusion Criteria:

* Any physical or psychological disability that would impact study participation, such as severe cerebrovascular disease (e.g., hemiparesis, cerebellar ataxia, etc.) or dementia
* Serum intact parathyroid hormone(iPTH)\>250 pmol/L within 30 days prior to screening visit
* Dysrhythmia or severe cardiac disease, such as congestive heart failure (CHF) Class III-IV, or unstable cardiovascular disease within 90 days prior to recruitment
* Severe peripheral arterial disease
* Severe hyperkalemia (\>6.5 milliequivalent/L) consistently the last 2 weeks
* Current active cancer (excluding basal cell carcinoma of the skin)
* Poorly controlled hypertension (post-dialytic systolic blood pressure ≥ 160mmHg or diastolic blood pressure≥ 100 mmHg) within 4 weeks prior to recruitment
* Anticipated living donor kidney transplant or any other planned major surgery over the study duration
* History of poor treatment adherence

Answer: D