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成年人慢性肾脏病(CKD)的有氧运动:一项荟萃分析。

Aerobic exercise in adults with chronic kidney disease (CKD): a meta-analysis.

机构信息

Division of Nephrology, Department of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.

出版信息

Int Urol Nephrol. 2019 Oct;51(10):1787-1795. doi: 10.1007/s11255-019-02234-x. Epub 2019 Jul 22.

Abstract

PURPOSE

Patients with chronic kidney disease (CKD) are frail and have high risk of cardiovascular disease. This study was performed to assess the effects of aerobic exercise training in adults with CKD.

METHODS

MEDLINE, EMBASE, CENTRAL, Web of Science were searched up to December 2018 to identify eligible randomized controlled trials (RCTs) that studied aerobic exercise in adults with CKD. Primary outcomes include oxygen consumption at peak exercise (VO peak), exercise capacity, blood pressure, heart rate, and health-related quality of life (HRQoL). Statistical analysis was performed using Review Manager 5.2.1 software.

RESULTS

Thirty-one trials, containing 1305 adults with CKD, were included. The most used aerobic exercise program was characterized as moderate intensity (15/31), 3 times/week frequency (22/31), 30 min duration (9/31) and 3 months follow-up (12/31). Significant improvement was observed in cardiorespiratory function (VO peak) (P < 0.0001), exercise duration (P < 0.0001), HDL-C (P = 0.03) and pain (P = 0.007), physical role (P = 0.03), general health (P = 0.007) of HRQoL after aerobic exercise in patients with CKD. A marginal difference was observed in HR max (P = 0.07). However, no statistical difference was noticed in exercise capacity, blood pressure, resting heart rate, serum lipid and serum creatinine between aerobic training group and control. No subgroup differences were altered in all outcomes when studies were divided based on intensity of exercise training, the treatment of dialysis or the length of intervention.

CONCLUSIONS

Aerobic exercise training could benefit adult CKD patients in increasing cardiorespiratory function, exercise duration, HDL-C level and improve health quality of life.

摘要

目的

患有慢性肾脏病(CKD)的患者身体虚弱,心血管疾病风险高。本研究旨在评估有氧运动训练对 CKD 成年患者的影响。

方法

检索 MEDLINE、EMBASE、CENTRAL、Web of Science,截至 2018 年 12 月,以确定纳入 CKD 成年患者有氧运动的合格随机对照试验(RCT)。主要结局包括峰值运动时的耗氧量(VO peak)、运动能力、血压、心率和健康相关生活质量(HRQoL)。使用 Review Manager 5.2.1 软件进行统计分析。

结果

共纳入 31 项试验,包含 1305 例 CKD 成人患者。最常用的有氧运动方案为中等强度(15/31)、每周 3 次(22/31)、每次 30 分钟(9/31)、随访 3 个月(12/31)。有氧运动后,心肺功能(VO peak)(P < 0.0001)、运动时间(P < 0.0001)、高密度脂蛋白胆固醇(HDL-C)(P = 0.03)和疼痛(P = 0.007)、身体角色(P = 0.03)、一般健康(P = 0.007)等 HRQoL 指标均有显著改善。HR max(P = 0.07)略有差异。然而,有氧运动组与对照组之间在运动能力、血压、静息心率、血脂和血清肌酐方面无统计学差异。根据运动训练强度、透析治疗或干预时间的不同,将研究分为亚组后,所有结局均未发现亚组差异。

结论

有氧运动训练可改善 CKD 成年患者的心肺功能、运动时间、HDL-C 水平,提高健康相关生活质量。

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