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系统评价和荟萃分析运动干预对肾移植受者疗效的影响。

Systematic review and meta-analysis of the efficacy of exercise intervention in kidney transplant recipients.

机构信息

Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Institute of Urology, Capital Medical University, Beijing, China.

出版信息

World J Urol. 2023 Dec;41(12):3449-3469. doi: 10.1007/s00345-023-04673-9. Epub 2023 Oct 26.

Abstract

BACKGROUND AND OBJECTIVE

There is uncertainty about the beneficial effects of exercise intervention for kidney transplant recipients. The purpose of our meta-analysis is to estimate the efficacy of exercise intervention in kidney transplant recipients.

METHODS

A database search according to the PICOS framework was performed for all published randomized, double-blind, placebo-controlled trials (RCTs) about exercise intervention for kidney transplant recipients. The databases involved include PubMed, Embase, and Cochrane Library.

RESULTS

A total of 16 RCTs (involving 827 patients) in compliance with inclusion criteria were included in our study. The results demonstrated that adequate exercise intervention improved statistically in creatinine clearance [mean difference (MD) =  - 0.29, 95% confidence interval (CI) - 0.46 to - 0.11, p = 0.001], serum urea (MD = - 21.57, 95% CI - 35.84 to - 7.29, p = 0.003), VO peak (MD = 3.20, 95% CI 1.97-4.43, p < 0.00001), high-density lipoprotein-cholesterol (HDL-C) (MD = 0.21, 95% CI 0.04-0.37, p = 0.01), 60-s sit to stand test (60-STS) (MD = 14.47, 95% CI 8.89-20.04, p < 0.00001), 6-min walk distance (6-MWD) (MD = 91.87, 95% CI 38.34-145.39, p = 0.0008), and 6-min walk test (6-MWT) (MD = 44.08, 95% CI 20.30-67.87, p = 0.0003) of patients after kidney transplantation. No between-groups differences (p > 0.05) were observed for anthropometric characteristics, body composition, serum cytokine levels, and quality of life short form-36 questionnaire (SF-36).

CONCLUSIONS

In kidney transplant recipients, appropriate exercise intervention improved renal function, cardiopulmonary function, physical performance.

TRIAL REGISTRATION

The PROSPERO registration number is CRD42022357574.

摘要

背景与目的

对于接受肾移植的患者,运动干预的有益效果尚不确定。本荟萃分析的目的是评估运动干预对肾移植受者的疗效。

方法

根据 PICOS 框架对所有已发表的关于肾移植受者运动干预的随机、双盲、安慰剂对照试验(RCT)进行数据库检索。所涉及的数据库包括 PubMed、Embase 和 Cochrane Library。

结果

共有 16 项符合纳入标准的 RCT(涉及 827 例患者)纳入本研究。结果表明,适当的运动干预可显著改善肌酐清除率[均数差值(MD)=-0.29,95%置信区间(CI)-0.46 至-0.11,p=0.001]、血清尿素(MD=-21.57,95%CI-35.84 至-7.29,p=0.003)、峰值摄氧量(MD=3.20,95%CI 1.97-4.43,p<0.00001)、高密度脂蛋白胆固醇(HDL-C)(MD=0.21,95%CI 0.04-0.37,p=0.01)、60 秒坐站测试(60-STS)(MD=14.47,95%CI 8.89-20.04,p<0.00001)、6 分钟步行距离(6-MWD)(MD=91.87,95%CI 38.34-145.39,p=0.0008)和 6 分钟步行测试(6-MWT)(MD=44.08,95%CI 20.30-67.87,p=0.0003)。但两组间在人体测量特征、身体成分、血清细胞因子水平和健康调查简表 36 项问卷(SF-36)方面无差异(p>0.05)。

结论

在肾移植受者中,适当的运动干预可改善肾功能、心肺功能和身体机能。

试验注册

PROSPERO 注册号为 CRD42022357574。

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