**11. Serum phosphate levels in a group of haemodialysis patients**

Hyperphosphatemia, one of the comorbidities commonly associated with increased cardiovascular risk, is caused by reduced renal excretion of phosphate in CKD patients. Reduced hyperphosphatemia reduces the risk of vascular calcification in patients on pre-dialysis and MHD therapy. Medical intervention (active vitamin D, phosphate chelators, and calcimimetics) and diet are crucial in the treatment of mineral bone disorder-CKD. PA affects phosphate absorption in the gut.

According to a study, active HD patients had the highest levels of serum phosphate, and the link between the two was determined to be direct. The levels of serum phosphate were shown to be closely linked to those of serum calcium and albumin. An unanticipated rise in serum phosphate levels should be minimised and overall results should be improved by tailoring nutritional advice for chronic HD patients according to their amount of physical activity [97].

Patients who were hyperphosphatemic at baseline, but not the general population, did not improve appreciably following a 12-month moderate-intensity aerobic IDE, according to the results of another trial. The malnourished inflammation score remained constant throughout the study. A small but statistically insignificant rise in the QoL visual analogue scale was associated with IDE. Patients with hyperphosphatemia benefited the most from 45 minutes of aerobic IDE, which was reported to be both safe and effective [98].

Cycling on stationary cycles while getting haemodialysis was found to be a safe and helpful therapeutic intervention for individuals with end-stage renal disease in a recent RCT (ESRD). After an 8-week intervention, serum phosphate and parathyroid hormone levels improved dramatically, whereas albumin and calcium levels remained stable [99].

### **12. Conclusion**

Sedentary lifestyles and lack of regular physical activity are common among CKD patients. This way of living has a negative impact on HRQoL and raises the risk of disease and death. Physical activity enhances physiological, functional, quality of life (QoL), and psychological components when done on a regular basis. When used in conjunction with dialysis, it improves both efficiency and adherence. However, overcoming the obstacle to regular PE and prescribing personalised PPE to CKD patients should be prioritised.

*Effect of Exercise on Health-Related Quality of Life in Patients with End-Stage Renal Disease DOI: http://dx.doi.org/10.5772/intechopen.101133*
