Abstract
BackgroundThe reported prevalence rate of depressive symptoms in hemodialysis patients is 40%. Although appropriate management of these symptoms is important, they remain under-recognized and under-treated in hemodialysis patients. Here, we systematically reviewed relevant randomized controlled trials (RCTs) investigating the effects of supervised exercise training on depressive symptoms in hemodialysis patients.MethodsMEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, CINAHL, Web of Science, PsycINFO, and PEDro databases were searched from the start until June 2016 for RCTs published in English evaluating the effects of supervised exercise training in hemodialysis patients. The main outcome measures were depressive symptoms.ResultsFrom a total of 10,923 screened references, five trials were included in the analysis. Exercise training was shown to significantly improve depressive symptoms in comparison with controls (standardized mean difference, SMD = − 1.19; P < 0.001) under a random effects model. Subgroup analyses indicated that aerobic exercise and interventions lasting ≥ 6 months significantly reduced depressive symptoms in hemodialysis patients (P = 0.016, P < 0.001, respectively).ConclusionsThe meta-analysis found that supervised exercise training tends to alleviate depressive symptoms in hemodialysis patients. As our database search identified only a small number of studies on the association between exercise and depressive symptoms, we would surmise that additional high-quality studies are required to explore further this association.Trial registrationPROSPERO, CRD42015020701.
Highlights
The reported prevalence rate of depressive symptoms in hemodialysis patients is 40%
This review is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Additional file 1) and is one of a series of systematic reviews regarding the effects of exercise on depressive symptoms in hemodialysis patients
Subgroup analyses indicated significant reductions in depressive symptoms among hemodialysis patients associated with aerobic exercise and interventions lasting ≥ 6 months (P = 0.016, P < 0.001, respectively)
Summary
The reported prevalence rate of depressive symptoms in hemodialysis patients is 40%. Appropriate management of these symptoms is important, they remain under-recognized and under-treated in hemodialysis patients. We systematically reviewed relevant randomized controlled trials (RCTs) investigating the effects of supervised exercise training on depressive symptoms in hemodialysis patients. Depressive symptoms are common among hemodialysis patients, with a prevalence rate of 40% according to the Dialysis Outcomes and Practice Patterns Study (DOPPS) [2]. The appropriate management of depressive symptoms as a patient-reported outcome (PRO) is known to be clinically important, these symptoms remain underrecognized and under-treated in dialysis patients [9,10,11]. Systematic reviews with meta-analyses are generally considered good means of determining the efficacy and effectiveness of treatments on selected outcomes
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