Exercise training and chronic kidney disease: characterization and bibliometrics of citation classics of clinical intervention trials

Abstract

Background: Exercise research targeting chronic kidney disease (CKD) has been conducted for more than 30 years, and the benefits of exercise for CKD patients have been progressively demonstrated. This study analyzes citation classics on clinical intervention trials on exercise training and CKD to describe the research landscape and hotspots through bibliometric analysis.

Methods: To identify clinical trials of exercise training interventions for CKD with more than 100 citations from the Web of Science Core Collection database. Extracted bibliometric information, participant information, and study characteristics of the included articles. The total citations, annual average citations, publication of year, author keywords, and study-related data were bibliometric analyzed and described using Excel 2019 and VOSviewer software.

Results: A total of 30 citation classics were included, with a total citation frequency of 102 to 279 (mean ± standard deviation: 148.4 ± 49.4). The American Journal of Kidney Diseases (n = 7) published the most (n = 7) classic citations in the field of CKD exercise research, and the Journal of the American Society of Nephrology was the most cited. The hotspot of research around CKD and exercise training interventions focused on population (hemodialysis and end-stage renal disease), exercise type (resistance training, yoga, and leg-cycling), and outcomes (cardiovascular indices, physical performance, psychological status, kidney function, physical activity). Reported dropout rates ranged from 0.0% to 47.4%.

Conclusion: A bibliometric analysis of citation classics on exercise training and CKD highlights the potential benefits of exercise as a non-pharmacological therapy for patients with CKD, as well as developments and hotspots in the field.

Keywords: Bibliometric analysis; chronic kidney disease; citation classics; exercise training.

Figure 1.

Hot-map of total citations for classic citations in clinical trials of exercise training and CKD. Note: we coded classical citations from highest to lowest total number of citations, consistent with the numbering in Table S1.

Figure 2.

Keyword co-occurrence analysis.

Figure 3.

Study characteristics of 30 classic citations. Note: (A) Over half of the 30 citation classics were randomized controlled trials, with six single-arm trials and quasi-experimental studies, respectively. (B) For the study population, more than 3/4 were hemodialysis-dependent CKD patients, only one study recruited kidney transplant recipients, and no separate clinical studies included peritoneal dialysis patients. (C) Regarding exercise type, aerobic exercise was reported in 55% of the studies, with a comparable proportion of combined exercise and resistance training. (D) Thirty citation classics reported exercise durations that fluctuated considerably between years, with the longest being 48 weeks.

Figure 4.

Sample size and dropout rate of 30 classic citations.