运动对糖尿病肾病肾功能的影响——一项系统评价与荟萃分析

Effect of exercise on renal function in diabetic nephropathy-a systematic review and meta-analysis.

作者信息

Nataraj Megha, Maiya Arun G, Nagaraju Shankar P, Shastry Barkur A, Shivashankara Kaniyoor N

机构信息

Department of Physiotherapy, Centre for Diabetic Foot Care and Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

出版信息

J Taibah Univ Med Sci. 2022 Nov 21;18(3):526-537. doi: 10.1016/j.jtumed.2022.11.002. eCollection 2023 Jun.

DOI:10.1016/j.jtumed.2022.11.002

PMID:36818178

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9906014/

Abstract

Diabetic nephropathy causes cardiovascular complications among individuals with diabetes which results in decreased kidney function and overall physical decline. The objective of this systematic review was to determine effects of exercise on various renal function parameters amond individuals with type 2 diabetes and nephropathy. It was registered with PROSPERO (CRD42020198754). Total 6 databases (PubMed/Medline, Scopus, Web of Science, CINAHL, ProQuest, and Cochrane) were searched. Among 1734 records, only four randomized controlled trials were included. The review included a total of 203 participants (103 in the intervention group and 100 in the control/standard group) with type 2 diabetic nephropathy or stage 2,3, or 4 of chronic kidney disease. The meta-analysis showed no effects of exercise on serum creatinine, serum cystatin c and varied eGFR equations. However, exercise decreased urinary albumin to creatinine ratio, urinary protein to creatinine ratio, serum urea nitrogen, creatinine clearance, and urinary protein excretion while increasing urea clearance. Limited evidence on the reno-protective role of exercise demands future research in this direction.

摘要

糖尿病肾病会在糖尿病患者中引发心血管并发症，进而导致肾功能下降和整体身体机能衰退。本系统评价的目的是确定运动对2型糖尿病和肾病患者各种肾功能参数的影响。该研究已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42020198754）登记。共检索了6个数据库（PubMed/Medline、Scopus、Web of Science、CINAHL、ProQuest和Cochrane）。在1734条记录中，仅纳入了四项随机对照试验。该评价共纳入了203名患有2型糖尿病肾病或慢性肾脏病2、3或4期的参与者（干预组103人，对照组/标准组100人）。荟萃分析表明，运动对血清肌酐、血清胱抑素C以及不同的估算肾小球滤过率（eGFR）方程均无影响。然而，运动降低了尿白蛋白与肌酐比值、尿蛋白与肌酐比值、血清尿素氮、肌酐清除率和尿蛋白排泄，同时提高了尿素清除率。关于运动肾脏保护作用的证据有限，需要未来在该方向开展研究。