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. 2022 Sep 19;12(9):e054887.
doi: 10.1136/bmjopen-2021-054887.

Therapeutic effects of exercise interventions for patients with chronic kidney disease: an umbrella review of systematic reviews and meta-analyses

Fan Zhang  1 , Yan Bai  2 , Xing Zhao  2 , Liuyan Huang  1 , Weiqiong Wang  3 , Wenqin Zhou  4 , Huachun Zhang  5
Affiliations

Therapeutic effects of exercise interventions for patients with chronic kidney disease: an umbrella review of systematic reviews and meta-analyses

Fan Zhang et al. BMJ Open. .

Abstract

Objective: To conduct an overview of meta-analyses evaluating the impact of exercise interventions on improving health outcomes in patients with chronic kidney disease (CKD).

Design: An umbrella review of systematic review and meta-analyses of intervention trials was performed.

Data sources: PubMed, Web of Science, Embase and the Cochrane Database of Systematic Reviews were searched from inception to 9 March 2021 for relevant articles.

Eligibility criteria for selecting studies: Eligible meta-analyses compared the effects of usual care with and without exercise in patients with CKD. Health outcomes included those related to cardiovascular risk factors, physical fitness, dialysis-related symptoms, dialysis adequacy and health-related quality of life. Systematic reviews and meta-analyses that included fewer than 3 RCTs or fewer than 100 participants were excluded from the analysis.

Results: A total of 31 eligible systematic reviews and meta-analyses were included that assessed 120 outcomes. For physical fitness, there was a moderate effect size for cardiorespiratory fitness, muscle strength and body composition and small effect size for muscle endurance. The effect sizes for cardiovascular risk factors, dialysis-related symptoms and health-related quality of life outcomes were small. According to the Grading of Recommendations Assessment, Development and Evaluation framework, most outcomes were low or very low quality.

Conclusion: Exercise appears to be a safe way to affect concomitant cardiovascular risk factors, such as blood pressure, improve physical fitness and health-related quality of life and reduce dialysis-related symptoms in patients with CKD.

Prospero registration number: CRD42020223591.

Keywords: chronic renal failure; nephrology; rehabilitation medicine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of literature screening. CDSR, Cochrane Database of Systemic Review.
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References

    1. Zoccali C, Vanholder R, Massy ZA, et al. . The systemic nature of CKD. Nat Rev Nephrol 2017;13:344–58. 10.1038/nrneph.2017.52 - DOI - PubMed
    1. GBD Chronic Kidney Disease Collaboration . Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet 2020;395:709–33. 10.1016/S0140-6736(20)30045-3 - DOI - PMC - PubMed
    1. Yang C, Gao B, Zhao X, et al. . Executive summary for China kidney disease network (CK-NET) 2016 annual data report. Kidney Int 2020;98:1419–23. 10.1016/j.kint.2020.09.003 - DOI - PubMed
    1. Cheng H-T, Xu X, Lim PS, et al. . Worldwide epidemiology of diabetes-related end-stage renal disease, 2000-2015. Diabetes Care 2021;44:89-97. 10.2337/dc20-1913 - DOI - PubMed
    1. Roshanravan B, Robinson-Cohen C, Patel KV, et al. . Association between physical performance and all-cause mortality in CKD. J Am Soc Nephrol 2013;24:822–30. 10.1681/ASN.2012070702 - DOI - PMC - PubMed

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