Exercise to Prevent Muscle Mass and Functional Loss in Elderly Dialysis Patients

Inclusion Criteria:

   - Males and females aged 55-80 years undergoing maintenance hemodialysis (MHD) for at
   least three months and without other active/uncontrolled disease will be studied.

   - Exercise and usual care groups will be matched by age, body mass index (BMI), MHD
   duration, and protein intake using a stratified randomization approach.

   - Subjects will be required to be in the peak VO2 range of 10 to 20 ml/kg/min,
   equivalent to moderate functional impairment in patients with heart failure.

   - Subjects will be required to have dialysis treatment for >3 months with an average
   Kt/V 1.2, and be able to perform exercise safely.

Exclusion Criteria:

   - Current activity > 2 hrs/wk of moderate intensity exercise, temporary vascular access,
   uncontrolled diabetes mellitus, active vasculitis, active autoimmune disease,
   malignancy, severe obesity (BMI > 35), alcoholism or other recreational drug use,
   unstable cardiac disease (abnormal exercise test, angina, uncontrolled arrhythmias or
   myocardial infarction within three months), peripheral vascular disease (claudication
   with exercise), lung, liver or intestinal disease, those who are medically unstable
   and subjects who have received anabolic, catabolic or cytotoxic medications in the
   past 3 months.

   - The investigators will also exclude subjects with excessive previous exposure to
   radiation.