Exercise interventions for improving objective physical function in patients with end-stage kidney disease on dialysis: a systematic review and meta-analysis

American Journal of Physiology - Renal Physiology - Tập 316 Số 5 - Trang F856-F872 - 2019
Matthew J. Clarkson1, Paul N. Bennett2,3, Steve F. Fraser1, Stuart A. Warmington1
1Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
2Medical and Clinical Affairs, Satellite Healthcare, Adelaide, South Australia, Australia
3School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia

Tóm tắt

Patients with end-stage kidney disease on dialysis have increased mortality and reduced physical activity, contributing to impaired physical function. Although exercise programs have demonstrated a positive effect on physiological outcomes such as cardiovascular function and strength, there is a reduced focus on physical function. The aim of this review was to determine whether exercise programs improve objective measures of physical function indicative of activities of daily living for patients with end-stage kidney disease on dialysis. A systematic search of Medline, Embase, the Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature identified 27 randomized control trials. Only randomized control trials using an exercise intervention or significant muscular activation in the intervention, a usual care, nonexercising control group, and at least one objective measure of physical function were included. Participants were ≥18 yr of age, with end-stage kidney disease, undergoing hemo- or peritoneal dialysis. Systematic review of the literature and quality assessment of the included studies used the Cochrane Collaboration’s tool for assessing risk bias. A meta-analysis was completed for the 6-min walk test. Data from 27 studies with 1,156 participants showed that exercise, regardless of modality, generally increased 6-min walk test distance, sit-to-stand time or repetitions, and grip strength as well as step and stair climb times or repetitions, dynamic mobility, and short physical performance battery scores. From the evidence available, exercise, regardless of modality, improved objective measures of physical function for end-stage kidney disease patients undergoing dialysis. It is acknowledged that further well-designed randomized control trials are required.

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Tài liệu tham khảo

Australian Institute of Health and Welfare, 2014, Projections of the Prevalence of Treated End-Stage Kidney Disease in Australia 2012–2020

10.1093/ndt/gfr098

10.1164/ajrccm.166.1.at1102

10.1093/ckj/sfv099

10.1111/j.1525-139X.2009.00652.x

10.1111/sdi.12610

10.1016/j.krcp.2012.04.491

Bohm CJ, 2010, J Nephrol, 23, 235

10.1249/00005768-198205000-00012

10.3810/psm.2009.12.1746

10.1159/000446847

10.1681/ASN.2006121329

10.1093/ndt/gfp739

10.1080/026404102320761787

10.3109/0886022X.2013.780977

10.1093/ndt/gfr404

10.1053/ajkd.2002.36887

10.1136/bjsports-2016-096356

10.1111/j.1525-1594.2011.01302.x

10.1378/chest.123.2.387

10.1159/000369253

10.1080/09593985.2018.1443537

10.1111/nep.12285

10.1159/000355792

Greenwood S, 2014, Nephrol Dial Transplant, 29, 379

10.1139/apnm-2014-0357

10.1136/bmj.332.7541.563

10.1002/14651858.CD003236.pub2

10.1053/j.ajkd.2014.03.020

10.1136/bmj.327.7414.557

10.5812/numonthly.37443

10.1097/MNH.0000000000000165

10.1111/nep.12752

10.1111/j.1542-4758.2008.00269.x

10.1681/ASN.2007010009

10.1046/j.1523-1755.2000.00116.x

10.1053/j.ajkd.2009.12.018

10.1053/j.ajkd.2011.10.008

10.1681/ASN.2006010034

10.1080/02701367.1999.10608028

10.1053/j.ajkd.2009.09.025

10.1080/165019702317242695

10.1159/000286344

10.1891/0739-6686.31.235

10.2165/11536880-000000000-00000

10.1046/j.1365-2281.2002.00405.x

10.1093/ndt/gfq487

10.1097/MD.0000000000004134

10.1681/ASN.2016030378

10.1136/bjsports-2017-097542

10.1053/j.jrn.2014.06.010

10.1136/bmjopen-2015-010990

10.1111/j.1532-5415.2012.04161.x

10.1093/gerona/59.11.1207

10.1093/ndt/gfw296

10.1080/09638288.2018.1485181

10.1053/j.ackd.2007.10.004

10.1159/000076744

10.1053/ajkd.2003.50055

10.1053/j.ackd.2010.02.002

10.1111/j.1492-7535.2005.01136.x

10.1053/j.ajkd.2014.01.433

10.1097/MNH.0b013e328365b43a

10.1053/j.ackd.2009.08.009

10.3109/0886022X.2012.745727

10.1111/j.1532-5415.2006.00701.x

Reddenna L, 2014, Int J Pharm Res Allied Sci, 3, 1

10.2522/ptj.20080258

10.1123/japa.6.4.363

10.5935/0101-2800.20160052

10.4103/1319-2442.164571

10.1093/ndt/gfw191.02

10.1111/aor.12886

10.1001/jama.1995.03520290060030

Smart N, 2011, Nephrology (Carlton), 16, 626

10.1016/j.jsams.2013.01.005

10.4040/jkan.2012.42.7.947

Takhreem M, 2008, Medscape J Med, 10, 226

10.1136/bmjopen-2016-012085

10.1093/ndt/gfh560

10.1097/01.mnh.0000444821.87873.7b

10.1111/sms.12714

10.1136/bjsm.25.2.90

10.1093/ndt/gfq106

10.1177/0300060513509037

10.1093/ndt/gfy045

10.1016/j.ctim.2006.06.008

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American Journal of Physiology - Renal Physiology

Tập 316 Số 5

F856-F872

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