Abstract
BackgroundPatients with chronic kidney disease (CKD) have a high prevalence of cardiovascular diseases, which often lead to physical inactivity that correlates with CKD exacerbation. The benefits of regular exercise to cardiovascular health have been well established in healthy population and highly suggestive in patients with CKD. To further strengthen the evidence base for the management of CKD, this meta-analysis was performed to systematically evaluate the effects of exercise therapy on renal function, blood pressure, blood lipid and body mass index (BMI) in non-dialysis CKD patients.MethodsThis meta-analysis was conducted following a previous protocol. Randomized controlled trials (RCTs) examining the effects of exercise therapy in non-dialysis CKD patients were searched in Pubmed, Embase, Cochrane Library, and three major Chinese biomedical databases (CNKI, WANGFANG and VIP) from their start date to October 30th, 2018. The Cochrane systematic review methods were applied for quality assessment and data extraction, and Revman version 5.3 was used for systematic review and meta-analysis.Results13 RCTs, representing 421 patients with non-dialysis CKD, were included in this meta-analysis. Compared to the controls, exercise therapy brought an increase in eGFR (MD = 2.62, 95% CI:0.42 to 4.82, P = 0.02, I2 = 22%), and decreases in systolic blood pressure (SBP) (MD = -5.61, 95% CI:-8.99 to − 2.23, P = 0.001, I2 = 44%), diastolic blood pressure (DBP) (MD = -2.87, 95% CI:-3.65 to − 2.08, P < 0.00001, I2 = 16%) and BMI (MD = -1.32, 95% CI:-2.39 to − 0.25, P = 0.02, I2 = 0%) in non-dialysis CKD patients. Exercise therapy of short-term (< 3 months) decreased triglyceride (TG) level (P = 0.0006). However, exercise therapy did not significantly affect serum creatinine (SCr), total cholesterol (TC), high density lipoprotein (HDL) or low density lipoprotein (LDL) in non-dialysis CKD patients.ConclusionExercise therapy could benefit non-dialysis CKD patients by increasing eGFR while reducing SBP, DBP and BMI. Additionally, short-term intervention of exercise could decrease TG.
Highlights
Patients with chronic kidney disease (CKD) have a high prevalence of cardiovascular diseases, which often lead to physical inactivity that correlates with CKD exacerbation
We further examined the full text of these 27 studies and excluded those involved exercise therapy of longer than 12 months or heterogeneous patient populations, or failed to provide qualified endpoints or complete data for our meta-analysis
Our results showed that exercise intervention could bring an average increase of 2.62 ml/min/1.73m2 in estimated glomerular filtration rate (eGFR) in non-dialysis CKD patients, and the difference was statistically significant (MD = 2.62, 95% confidence interval (CI):0.42 to 4.82, P = 0.02)
Summary
Patients with chronic kidney disease (CKD) have a high prevalence of cardiovascular diseases, which often lead to physical inactivity that correlates with CKD exacerbation. To further strengthen the evidence base for the management of CKD, this meta-analysis was performed to systematically evaluate the effects of exercise therapy on renal function, blood pressure, blood lipid and body mass index (BMI) in non-dialysis CKD patients. Because of gradual muscle strength loss, uremic milieu and dialysis complications, the activity levels of CKD patients are markedly lower than those of healthy individuals, further deteriorating their basic activities of daily living and life quality, and increasing all-cause mortality [2, 3] Traditional risk factors, such as hypertension, diabetes, dislipidemia and obesity, promote CKD progression. In order to strengthen the theoretical basis for the management of CKD, we performed here a meta-analysis to systematically evaluate the effects of exercise therapy on renal function, blood pressure, blood lipids and BMI in non-dialysis CKD (stage 2–5) patients
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