Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, España.
Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, España.
Nefrologia (Engl Ed). 2020 May-Jun;40(3):237-252. doi: 10.1016/j.nefro.2020.01.002. Epub 2020 Apr 15.
Physical exercise may offer multiple benefits to patients with chronic kidney disease (CKD). However, it was not traditionally recommended because of the possibility of impairing renal function and increasing proteinuria. The objective of this study is to review the clinical trials on physical exercise in patients with CKD and describe its effect on the progression of kidney disease and other factors associated. Randomized clinical trials (RCT) comparing an intervention that included an exercise component with a control group without physical exercise in non-dialysis patients with CKD from 2007 to 2018 in English and Spanish were included. PubMed, Scopus, Embase, Ovid (Medline) and PEDro databases were used for the search. Effects of physical exercise were summarized by the standardized mean difference (SMD). No differences were found in glomerular filtration rate or proteinuria between the intervention group and the control group: SMD -0.3 (P=.81); SMD 26.6 (P=.82). Positive effects were obtained on peak oxygen consumption: SMD 2.5 (P<.001), functional capacity: SMD 56.6 (P<.001), upper limb strength: SMD 6.8 (P<.001) and hemoglobin: SMD 0.3 (P=.003). An improvement on the quality of life was also evident using the KDQOL-36 survey: SMD 3.56 (P=.02) and the SF-36 survey: SMD 6.66 (P=.02). In conclusion, the practice of low-intensity physical exercise routinely has no negative impact on renal function. On the contrary, it improves aerobic and functional capacity, impacting positively on the quality of life.
身体活动可能为慢性肾脏病（CKD）患者带来多种益处。然而，由于可能损害肾功能和增加蛋白尿，身体活动传统上并未被推荐。本研究的目的是综述 CKD 患者身体活动的临床试验，并描述其对肾脏疾病进展和其他相关因素的影响。纳入了 2007 年至 2018 年间在非透析 CKD 患者中进行的比较包含身体活动干预组和无身体活动对照组的随机临床试验（RCT），研究语言为英语和西班牙语。检索使用了 PubMed、Scopus、Embase、ovid（Medline）和 PEDro 数据库。身体活动的效果通过标准化均数差（SMD）进行总结。干预组和对照组之间肾小球滤过率或蛋白尿无差异：SMD -0.3（P=.81）；SMD 26.6（P=.82）。在峰值摄氧量方面获得了积极效果：SMD 2.5（P<.001），功能能力：SMD 56.6（P<.001），上肢力量：SMD 6.8（P<.001）和血红蛋白：SMD 0.3（P=.003）。使用 KDQOL-36 调查和 SF-36 调查也明显改善了生活质量：SMD 3.56（P=.02）和 SMD 6.66（P=.02）。总之，常规进行低强度身体活动对肾功能没有负面影响。相反，它可以改善有氧运动和功能能力，对生活质量产生积极影响。
