Aerobic exercise in adults with chronic kidney disease (CKD): a meta-analysis

Abstract

Purpose: Patients with chronic kidney disease (CKD) are frail and have high risk of cardiovascular disease. This study was performed to assess the effects of aerobic exercise training in adults with CKD.

Methods: MEDLINE, EMBASE, CENTRAL, Web of Science were searched up to December 2018 to identify eligible randomized controlled trials (RCTs) that studied aerobic exercise in adults with CKD. Primary outcomes include oxygen consumption at peak exercise (VO₂ peak), exercise capacity, blood pressure, heart rate, and health-related quality of life (HRQoL). Statistical analysis was performed using Review Manager 5.2.1 software.

Results: Thirty-one trials, containing 1305 adults with CKD, were included. The most used aerobic exercise program was characterized as moderate intensity (15/31), 3 times/week frequency (22/31), 30 min duration (9/31) and 3 months follow-up (12/31). Significant improvement was observed in cardiorespiratory function (VO₂ peak) (P < 0.0001), exercise duration (P < 0.0001), HDL-C (P = 0.03) and pain (P = 0.007), physical role (P = 0.03), general health (P = 0.007) of HRQoL after aerobic exercise in patients with CKD. A marginal difference was observed in HR max (P = 0.07). However, no statistical difference was noticed in exercise capacity, blood pressure, resting heart rate, serum lipid and serum creatinine between aerobic training group and control. No subgroup differences were altered in all outcomes when studies were divided based on intensity of exercise training, the treatment of dialysis or the length of intervention.

Conclusions: Aerobic exercise training could benefit adult CKD patients in increasing cardiorespiratory function, exercise duration, HDL-C level and improve health quality of life.

Keywords: Aerobic exercise training; Chronic kidney disease; Meta-analysis.