BACKGROUND AND OBJECTIVE: Hemodialysis (HD) patients are more inactive, leading to poor functional capacity and quality of life; this may be reversed with intradialytic exercise training. To systematically evaluate the efficacy and safety of intradialytic exercise for HD patients, we conducted a meta-analysis of the published randomized controlled trials. DATA SOURCES AND METHODS: Medline, Embase, and Cochrane Central Register of Controlled Trials were systematically searched up to February, 2014. The reference lists of eligible studies and relevant reviews were also checked. RESULTS: 24 studies of 997 patients were included. Compared with control, intradialytic exercise significantly improve Kt/V (SMD = 0.27, 95% CI 0.01-0.53), peak oxygen consumption (VO(2peak)) (SMD = 0.53, 95% CI 0.30-0.76), and physical performance of physical function of life (SMD = 0.30, 95% CI 0.04-0.55). However, no significant improvements were found in the mental function of life. There was no significant difference with respect to musculoskeletal and cardiovascular complications between the intradialytic exercise groups and control groups. Further subgroup analysis found that, when the trial duration was more than 6 months, the intervention had significant effects on VO(2peak) (SMD = 0.89, 95% CI 0.56-1.22). However, when the trial duration was less than 6 months, the change of VO(2peak) was not significant (SMD = 0.19, 95% CI -0.13 to 0.51). CONCLUSION: Intradialytic exercise can improve Kt/V, VO(2peak), and the physical quality of life, and intradialytic exercise is safe for HD patients. Therefore, we put forward the suggestion that clinical guideline be updated to inform clinicians on the benefits of intradialytic exercise on HD patients.
BACKGROUND AND OBJECTIVE: Hemodialysis (HD) patients are more inactive, leading to poor functional capacity and quality of life; this may be reversed with intradialytic exercise training. To systematically evaluate the efficacy and safety of intradialytic exercise for HDpatients, we conducted a meta-analysis of the published randomized controlled trials. DATA SOURCES AND METHODS: Medline, Embase, and Cochrane Central Register of Controlled Trials were systematically searched up to February, 2014. The reference lists of eligible studies and relevant reviews were also checked. RESULTS: 24 studies of 997 patients were included. Compared with control, intradialytic exercise significantly improve Kt/V (SMD = 0.27, 95% CI 0.01-0.53), peak oxygen consumption (VO(2peak)) (SMD = 0.53, 95% CI 0.30-0.76), and physical performance of physical function of life (SMD = 0.30, 95% CI 0.04-0.55). However, no significant improvements were found in the mental function of life. There was no significant difference with respect to musculoskeletal and cardiovascular complications between the intradialytic exercise groups and control groups. Further subgroup analysis found that, when the trial duration was more than 6 months, the intervention had significant effects on VO(2peak) (SMD = 0.89, 95% CI 0.56-1.22). However, when the trial duration was less than 6 months, the change of VO(2peak) was not significant (SMD = 0.19, 95% CI -0.13 to 0.51). CONCLUSION: Intradialytic exercise can improve Kt/V, VO(2peak), and the physical quality of life, and intradialytic exercise is safe for HDpatients. Therefore, we put forward the suggestion that clinical guideline be updated to inform clinicians on the benefits of intradialytic exercise on HDpatients.
Authors: Jon Kobashigawa; Darshana Dadhania; Sangeeta Bhorade; Deborah Adey; Joseph Berger; Geetha Bhat; Marie Budev; Andres Duarte-Rojo; Michael Dunn; Shelley Hall; Meera N Harhay; Kirsten L Johansen; Susan Joseph; Cassie C Kennedy; Evan Kransdorf; Krista L Lentine; Raymond J Lynch; Mara McAdams-DeMarco; Shunji Nagai; Michael Olymbios; Jignesh Patel; Sean Pinney; Joanna Schaenman; Dorry L Segev; Palak Shah; Lianne G Singer; Jonathan P Singer; Christopher Sonnenday; Puneeta Tandon; Elliot Tapper; Stefan G Tullius; Michael Wilson; Martin Zamora; Jennifer C Lai Journal: Am J Transplant Date: 2018-12-22 Impact factor: 8.086
Authors: Maria Isabel Fuhro; Gilson P Dorneles; Francini P Andrade; Pedro R T Romão; Alessandra Peres; Mariane B Monteiro Journal: Int Urol Nephrol Date: 2017-11-13 Impact factor: 2.370
Authors: Damien Ashby; Natalie Borman; James Burton; Richard Corbett; Andrew Davenport; Ken Farrington; Katey Flowers; James Fotheringham; R N Andrea Fox; Gail Franklin; Claire Gardiner; R N Martin Gerrish; Sharlene Greenwood; Daljit Hothi; Abdul Khares; Pelagia Koufaki; Jeremy Levy; Elizabeth Lindley; Jamie Macdonald; Bruno Mafrici; Andrew Mooney; James Tattersall; Kay Tyerman; Enric Villar; Martin Wilkie Journal: BMC Nephrol Date: 2019-10-17 Impact factor: 2.388
Authors: Fatima Warsame; Hao Ying; Christine E Haugen; Alvin G Thomas; Deidra C Crews; Tariq Shafi; Bernard Jaar; Nadia M Chu; Dorry L Segev; Mara A McAdams-DeMarco Journal: Am J Nephrol Date: 2018-09-03 Impact factor: 3.754
Authors: Sharlene A Greenwood; Pelagia Koufaki; Jamie H Macdonald; Catherine Bulley; Sunil Bhandari; James O Burton; Indranil Dasgupta; Kenneth Farrington; Ian Ford; Philip A Kalra; Mick Kumwenda; Iain C Macdougall; Claudia-Martina Messow; Sandip Mitra; Chante Reid; Alice C Smith; Maarten W Taal; Peter C Thomson; David C Wheeler; Claire White; Magdi Yaqoob; Thomas H Mercer Journal: Health Technol Assess Date: 2021-06 Impact factor: 4.014
Authors: Meera N Harhay; Maya K Rao; Kenneth J Woodside; Kirsten L Johansen; Krista L Lentine; Stefan G Tullius; Ronald F Parsons; Tarek Alhamad; Joseph Berger; XingXing S Cheng; Jaqueline Lappin; Raymond Lynch; Sandesh Parajuli; Jane C Tan; Dorry L Segev; Bruce Kaplan; Jon Kobashigawa; Darshana M Dadhania; Mara A McAdams-DeMarco Journal: Nephrol Dial Transplant Date: 2020-07-01 Impact factor: 5.992