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- Intradialytic exercise in hemodialysis patients - Implementation and effectiveness on long-term patient outcomesPublication . Martins, Pedro Miguel PereiraHemodialysis (HD) patients have high levels of inactivity that are associated with poor health outcomes. Since 2005, the National Kidney Foundation guidelines (Kidney Disease Outcomes Quality Initiative) recommend chronic kidney disease (CKD) patients to perform aerobic exercise for 30 minutes most, if not all, days per week (1). Apparently, this ambiguous recommendation have not inspired the nephrology community to improve physical activity (PA) levels, since inactivity remains an hallmark of this population (2). This thesis includes a systematic review in which PA was associated with a lower mortality risk in end-stage kidney disease (ESKD) patients. Intradialytic exercise (IDE) could be a strategy to improve PA, since it is convenient for HD patients, being its implementation recommended by the UK Kidney Association (UKKA) (3). Nevertheless, little is known about the implementation and scalability of IDE and about its effectiveness in real-world conditions, including its association with relevant endpoints for this population.