Thangarasa Tharshika, Imtiaz Rameez, Hiremath Swapnil, Zimmerman Deborah
University of Ottawa, ON, Canada.
Department of Medicine, The Ottawa Hospital, Kidney Research Centre of the Ottawa Hospital Research Institute, ON, Canada.
Can J Kidney Health Dis. 2018 Jun 18;5:2054358118779821. doi: 10.1177/2054358118779821. eCollection 2018.
Exercise has been shown to be of benefit in the general population and in patients with chronic diseases. Despite a lack of compelling evidence, patients with end-stage kidney disease (ESKD) treated with peritoneal dialysis (PD) are often discouraged from participating in exercise programs that include weight lifting due to concerns about the development of hernias and leaks. The actual effects of physical activity with or without structured exercise programs for patients on PD remain unclear.
To determine the risks and benefits of physical activity in the ESKD population treated with PD.
Systematic review and meta-analysis.
Included all studies that met our criteria regardless of country of origin.
Adult patients with ESKD treated with PD.
Descriptive and quantitative analysis of our primary and secondary outcome variables.
We searched MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials for observational and interventional studies examining the effects of physical activity in patients on PD. A systematic review and meta-analysis was conducted of the identified studies. The primary outcomes of interest included patient-centered outcomes of mental health, physical functioning, fatigue, quality of life, and adverse events. Secondary outcomes included nutritional measures, lipid profile, blood pressure changes, maximum heart rate, resting heart rate, maximal oxygen consumption, muscle development, cognitive function, and markers of inflammation.
Of 1828 studies identified by the literature search, 12 met the inclusion criteria including 6 interventional and 6 observational studies. There was limited information on the patient important outcomes. However, there is some evidence for improvements in burden of kidney disease, physical function, and some mental health measures with physical activity.
Lack of well-designed randomized controlled trials impaired our ability to determine the benefits and risks of increasing physical activity.
There is limited evidence of benefit with increased levels of physical activity in PD patients. Further research is needed to define the exercise program that is likely to be of most benefit to patients treated with PD.
运动已被证明对普通人群和慢性病患者有益。尽管缺乏确凿证据，但由于担心发生疝气和渗漏，接受腹膜透析（PD）治疗的终末期肾病（ESKD）患者通常不被鼓励参加包括举重在内的运动项目。对于接受PD治疗的患者，有或没有结构化运动项目的体育活动的实际效果仍不清楚。
确定体育活动对接受PD治疗的ESKD人群的风险和益处。
系统评价和荟萃分析。
纳入所有符合我们标准的研究，无论其原产国。
接受PD治疗的成年ESKD患者。
对我们的主要和次要结局变量进行描述性和定量分析。
我们检索了MEDLINE、Embase、CINAHL和Cochrane对照试验中央注册库，以查找观察性和干预性研究，这些研究考察了体育活动对接受PD治疗患者的影响。对已识别的研究进行了系统评价和荟萃分析。感兴趣的主要结局包括以患者为中心的心理健康、身体功能、疲劳、生活质量和不良事件结局。次要结局包括营养指标、血脂谱、血压变化、最大心率、静息心率、最大耗氧量、肌肉发育、认知功能和炎症标志物。
在文献检索中确定的1828项研究中，12项符合纳入标准，包括6项干预性研究和6项观察性研究。关于对患者重要结局的信息有限。然而，有一些证据表明体育活动可改善肾病负担、身体功能和一些心理健康指标。
缺乏设计良好的随机对照试验削弱了我们确定增加体育活动的益处和风险的能力。
体育活动水平增加对PD患者有益的证据有限。需要进一步研究来确定可能对接受PD治疗的患者最有益的运动项目。
