Department of Nephrology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Cardiology, LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
BMJ Open. 2022 Sep 19;12(9):e054887. doi: 10.1136/bmjopen-2021-054887.
To conduct an overview of meta-analyses evaluating the impact of exercise interventions on improving health outcomes in patients with chronic kidney disease (CKD).
An umbrella review of systematic review and meta-analyses of intervention trials was performed.
PubMed, Web of Science, Embase and the Cochrane Database of Systematic Reviews were searched from inception to 9 March 2021 for relevant articles.
Eligible meta-analyses compared the effects of usual care with and without exercise in patients with CKD. Health outcomes included those related to cardiovascular risk factors, physical fitness, dialysis-related symptoms, dialysis adequacy and health-related quality of life. Systematic reviews and meta-analyses that included fewer than 3 RCTs or fewer than 100 participants were excluded from the analysis.
A total of 31 eligible systematic reviews and meta-analyses were included that assessed 120 outcomes. For physical fitness, there was a moderate effect size for cardiorespiratory fitness, muscle strength and body composition and small effect size for muscle endurance. The effect sizes for cardiovascular risk factors, dialysis-related symptoms and health-related quality of life outcomes were small. According to the Grading of Recommendations Assessment, Development and Evaluation framework, most outcomes were low or very low quality.
Exercise appears to be a safe way to affect concomitant cardiovascular risk factors, such as blood pressure, improve physical fitness and health-related quality of life and reduce dialysis-related symptoms in patients with CKD.
CRD42020223591.
对评估运动干预改善慢性肾脏病（CKD）患者健康结局的影响的荟萃分析进行综述。
对干预试验的系统评价和荟萃分析进行了伞式综述。
从建库到 2021 年 3 月 9 日，检索了 PubMed、Web of Science、Embase 和 Cochrane 系统评价数据库，以获取相关文章。
符合条件的荟萃分析比较了 CKD 患者常规护理加运动与不加运动的效果。健康结果包括与心血管危险因素、身体适应性、透析相关症状、透析充分性和健康相关生活质量相关的结果。从分析中排除了仅包含少于 3 项 RCT 或少于 100 名参与者的系统评价和荟萃分析。
共纳入 31 项符合条件的系统评价和荟萃分析，评估了 120 项结果。在身体适应性方面，心肺适应性、肌肉力量和身体成分的效应量为中度，肌肉耐力的效应量为小。心血管危险因素、透析相关症状和健康相关生活质量结果的效应量较小。根据推荐评估、制定和评估框架的分级，大多数结果的质量为低或极低。
运动似乎是一种安全的方法，可以影响并存的心血管危险因素，如血压，改善身体适应性和健康相关生活质量，并减少 CKD 患者的透析相关症状。
PROSPERO 注册号：CRD42020223591。
