Jeong JH, Biruete A, Tomayko EJ, et al. - Researchers examined whether physical function, risk of cardiovascular disease (CVD), and quality of life (QOL) in hemodialysis (HD) patients could be improved via implementing 12 months of intradialytic protein supplementation and endurance exercise in a randomized controlled trial. For 12 months, they assigned a total of 138 HD patients (average age 58 years) to control, intradialytic protein, or protein plus exercise groups. The intervention was completed by a total of 101 patients. The groups showed no significant differences in shuttle walk test performance from baseline to 12 months. The protein and protein plus exercise groups showed trends for improvements in some secondary measures of physical function and strength at six or 12 months, however, these did not reach statistical significance. Hence, no significant improvements in markers of physical function, risk of CVD or QOL after one year of intradialytic oral OPS and aerobic exercise training were illustrated in this trial. Findings suggest the necessity for more comprehensive lifestyle management to uncover robust improvements in the health and QOL of HD patients.