{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:30:16Z","timestamp":1786710616397,"version":"build-2736575974"},"reference-count":71,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Endocrinol Diabetes"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus (T2DM) is the leading global cause of end-stage kidney disease (ESRD). Patients receiving hemodialysis often have a high cardiometabolic risk profile, including insulin resistance, glycemic variability, chronic inflammation, sarcopenia, and altered mineral metabolism. In this setting, standard glycemic markers are often unreliable, supporting the use of additional non-pharmacological strategies, particularly structured physical activity, alongside standard treatment. This narrative review synthesizes current evidence on metabolic dysregulation in hemodialysis patients with T2DM and evaluates the potential role of intradialytic exercise as a multi-target intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A focused narrative search was conducted in PubMed, Scopus and Web of Science (2014\u20132025). Randomized trials, observational studies, clinical guidelines and narrative reviews addressing key metabolic and musculoskeletal complications, CKD-MBD, and intradialytic exercise in advanced kidney disease were considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intradialytic exercise represents a feasible adjunct strategy targeting interconnected metabolic pathways in patients with T2DM and ESRD. Further large-scale prospective studies are warranted to define the optimal intensity, modality and timing of intradialytic exercise and to clarify its long-term cardiometabolic and clinical benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795514261473664","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T18:20:06Z","timestamp":1786472406000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Type 2 Diabetes and Hemodialysis: Metabolic Challenges and the Role of Intradialytic Exercise"],"prefix":"10.1177","volume":"19","author":[{"given":"Lola T.","family":"Daminova","sequence":"first","affiliation":[{"name":"Tashkent State Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0119-9288","authenticated-orcid":false,"given":"Sitorakhon U.","family":"Muminova","sequence":"additional","affiliation":[{"name":"Tashkent State Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine R.","family":"Tuttle","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Botir T.","family":"Daminov","sequence":"additional","affiliation":[{"name":"Republican Specialized Scientific and Practical Medical Center of Nephrology and Transplantation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shavkat K.","family":"Muminov","sequence":"additional","affiliation":[{"name":"Tashkent State Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Durdona Sh.","family":"Adilova","sequence":"additional","affiliation":[{"name":"Tashkent State Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guzal B.","family":"Kasimova","sequence":"additional","affiliation":[{"name":"Tashkent State Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaf177"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)01853-7"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.11491116"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2024.01.001"},{"issue":"160","key":"e_1_3_7_6_2","first-page":"103","article-title":"Dynamics of the development of hemodialysis service in the Republic of Uzbekistan","volume":"2","author":"Kholikov AY","year":"2025","unstructured":"Kholikov AY, Sobirov MA, Bozaripov SJ. Dynamics of the development of hemodialysis service in the Republic of Uzbekistan. Probl Biol Med. 2025;2(160):103-108.","journal-title":"Probl Biol Med"},{"key":"e_1_3_7_7_2","volume-title":"USRDS 2024 Annual Data Report: end-stage renal disease","author":"United States Renal Data System","year":"2024","unstructured":"United States Renal Data System. USRDS 2024 Annual Data Report: end-stage renal disease. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases; 2024. Available at: https:\/\/usrds-adr.niddk.nih.gov\/2024\/end-stage-renal-disease\/6-mortality"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.03.1970"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12226984"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.4103\/aam.aam_18_19"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020633"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.krcp.2015.02.004"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.4103\/1110-6611.254615"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcrm1010004"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21010263"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.00098.2019"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2020.00519"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13020352"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2022.338"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S410834"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/nu16010172"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.3390\/biom12040542"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.3390\/biom5010194"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.931473"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S305054"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.3390\/metabo15080515"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-0269"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57070712"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci21-0035"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.k10e-138"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2018.07.004"},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-021-01699-6"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci22-0027"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc25-S011"},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2021.07.007"},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.japh.2023.06.003"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2016(01)08"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2024.11.013"},{"key":"e_1_3_7_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2014.09.008"},{"key":"e_1_3_7_40_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv206"},{"key":"e_1_3_7_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2020.10.003"},{"key":"e_1_3_7_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2017.04.001"},{"issue":"1","key":"e_1_3_7_43_2","first-page":"gfae069.1746","article-title":"FGF23 in diabetic kidney disease and atherosclerosis","volume":"39","author":"Donate-Correa J","year":"2024","unstructured":"Donate-Correa J, Mart\u00edn-N\u00fa\u00f1ez E, Hern\u00e1ndez-Carballo C, et al. FGF23 in diabetic kidney disease and atherosclerosis. Nephrol Dial Transplant. 2024;39(Suppl 1):gfae069.1746.","journal-title":"Nephrol Dial Transplant"},{"key":"e_1_3_7_44_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2012.176"},{"key":"e_1_3_7_45_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0190"},{"key":"e_1_3_7_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2025.01.024"},{"key":"e_1_3_7_47_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1059179"},{"key":"e_1_3_7_48_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2013050465"},{"key":"e_1_3_7_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.05.034"},{"key":"e_1_3_7_50_2","doi-asserted-by":"publisher","DOI":"10.31662\/jmaj.2024-0349"},{"key":"e_1_3_7_51_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-021-02235-4"},{"key":"e_1_3_7_52_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00038.2018"},{"key":"e_1_3_7_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cophys.2019.04.008"},{"key":"e_1_3_7_54_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-physiol-020518-114339"},{"key":"e_1_3_7_55_2","doi-asserted-by":"publisher","DOI":"10.3390\/metabo13070795"},{"key":"e_1_3_7_56_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12071188"},{"key":"e_1_3_7_57_2","doi-asserted-by":"publisher","DOI":"10.3390\/sports10030042"},{"key":"e_1_3_7_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2025.08.005"},{"key":"e_1_3_7_59_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-94257-x"},{"key":"e_1_3_7_60_2","doi-asserted-by":"publisher","DOI":"10.4103\/sjamf.sjamf_38_20"},{"key":"e_1_3_7_61_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph1817920"},{"key":"e_1_3_7_62_2","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S186674"},{"key":"e_1_3_7_63_2","doi-asserted-by":"publisher","DOI":"10.3390\/mps4030060"},{"key":"e_1_3_7_64_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2017-000414"},{"key":"e_1_3_7_65_2","doi-asserted-by":"publisher","DOI":"10.1002\/cphy.c190029"},{"key":"e_1_3_7_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajmo.2023.100031"},{"key":"e_1_3_7_67_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfae431"},{"key":"e_1_3_7_68_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2369-14-259"},{"key":"e_1_3_7_69_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-023-03327-7"},{"key":"e_1_3_7_70_2","doi-asserted-by":"publisher","DOI":"10.1111\/nep.14407"},{"key":"e_1_3_7_71_2","doi-asserted-by":"publisher","DOI":"10.21767\/2472-1158.100058"},{"key":"e_1_3_7_72_2","doi-asserted-by":"publisher","DOI":"10.4236\/aar.2016.51002"}],"container-title":["Clinical Medicine Insights: Endocrinology and Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795514261473664","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11795514261473664","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11795514261473664","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:31:11Z","timestamp":1786707071000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11795514261473664"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":71,"alternative-id":["10.1177\/11795514261473664"],"URL":"https:\/\/doi.org\/10.1177\/11795514261473664","relation":{},"ISSN":["1179-5514","1179-5514"],"issn-type":[{"value":"1179-5514","type":"print"},{"value":"1179-5514","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"article-number":"11795514261473664"}}