Wang Huan, Xie Dengpiao, Wu Lisheng, Zhao Liangbin
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Southern Medical University, Guangzhou, China.
Front Med (Lausanne). 2022 Jul 6;9:904299. doi: 10.3389/fmed.2022.904299. eCollection 2022.
Vascular function is associated with an increased risk of cardiovascular events in patients with chronic kidney disease (CKD). Whether exercise improves vascular function in such patients remains controversial. This study aimed to conduct a meta-analysis on the effect of exercise training on the vascular function of patients with CKD.
Embase, the Cochrane Central Register of Controlled Trials, and Medline were searched from inception until November 15, 2021. The terms exercise, CKD, dialysis, kidney transplant, and randomized controlled trial (RCT) were searched alone or in combination. RCTs were included when studies compared exercise with active control, usual care, or no intervention, and the studies reported vascular function on patients with CKD.
This meta-analysis included 18 RCTs with 817 patients. Exercise training was significantly associated with decreased pulse wave velocity weighted mean difference (WMD), -0.56; 95% confidence interval (CI), -1.02 to -0.09, = 0.02 and augmentation index (WMD, -3.26; 95% CI, -5.46 to -1.05, = 0.004). It was also significantly associated with improved peak VO2 (WMD, 2.64; 95% CI, 1.94-3.35, < 0.00001), general health (WMD, 7.03; 95% CI, 0.65-13.42, = 0.03), and vitality (WMD, 9.1; 95% CI, 2.50-15.69, = 0.007).
The meta-analysis suggested that exercise training improved vascular function in patients with CKD. An exercise program should be considered as one of the management strategies for vascular dysfunction in patients with CKD. Further studies are needed to demonstrate that exercise training improves cardiovascular diseases in patients with CKD.
血管功能与慢性肾脏病（CKD）患者心血管事件风险增加相关。运动是否能改善此类患者的血管功能仍存在争议。本研究旨在对运动训练对CKD患者血管功能的影响进行荟萃分析。
检索了Embase、Cochrane对照试验中央注册库和Medline，检索时间从建库至2021年11月15日。单独或组合检索“运动”“CKD”“透析”“肾移植”和“随机对照试验（RCT）”等术语。当研究将运动与积极对照、常规护理或无干预进行比较，且报告了CKD患者的血管功能时，纳入RCT。
本荟萃分析纳入了18项RCT，共817例患者。运动训练与脉搏波速度加权平均差（WMD）显著降低相关，为-0.56；95%置信区间（CI）为-1.02至-0.09，P = 0.02，与增强指数（WMD，-3.26；95%CI，-5.46至-1.05，P = 0.004）也显著相关。它还与峰值摄氧量改善显著相关（WMD，2.64；95%CI，1.94 - 3.35，P < 0.00001）、总体健康状况（WMD，7.03；95%CI，0.65 - 13.42，P = 0.03）和活力（WMD，9.1；95%CI，2.50 - 15.69，P = 0.007）显著相关。
荟萃分析表明运动训练可改善CKD患者的血管功能。运动方案应被视为CKD患者血管功能障碍管理策略之一。需要进一步研究来证明运动训练可改善CKD患者的心血管疾病。
