Zhou Xueyi, Bai Yan, Zhang Fan, Gu Min
Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Ren Fail. 2024 Dec;46(2):2436105. doi: 10.1080/0886022X.2024.2436105. Epub 2024 Dec 3.
To investigate whether exercise intervention is associated with reducing depressive symptoms in chronic kidney disease (CKD) patients.
Medline (PubMed), Web of Science, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to February 28, 2024. Randomized controlled trials comparing exercise intervention with usual care or stretching sessions for depression symptoms. Independent data extraction was conducted, and the quality of studies was assessed. A meta-analysis was carried out by using random effects models to calculate standardized mean difference (SMD) with a 95% confidence interval (95% CI) between groups.
23 trials with 1561 CKD patients were identified. Exercise interventions are associated with a significant reduction in depression symptoms among CKD patients, with a moderate average SMD of -0.726 (95% CI: -1.056, -0.396; =-4.57; < 0.001). Significant heterogeneity was observed (tau = 0.408 [95%CI: 0.227, 1.179], = 79.9% [95% CI: 70.5%, 86.3%]). The funnel plot shows potential publication bias. Subgroup analyses showed that the beneficial effects of exercise on depression remained constant across all subgroups. The evidence is deemed as 'very low' certainty.
Our systematic review and meta-analysis showed that exercise intervention was associated with significantly alleviating depression symptoms (certainty of evidence: very low). While the very low certainty of the evidence highlights a need for further research.
CRD42021248450.
探讨运动干预是否与降低慢性肾脏病（CKD）患者的抑郁症状相关。
检索Medline（PubMed）、科学网、Embase以及Cochrane对照试验中心注册库（CENTRAL），检索时间从建库至2024年2月28日。纳入比较运动干预与常规护理或伸展训练对抑郁症状影响的随机对照试验。进行独立的数据提取，并评估研究质量。采用随机效应模型进行荟萃分析，计算组间标准化均数差（SMD）及95%置信区间（95%CI）。
共纳入23项试验，涉及1561例CKD患者。运动干预与CKD患者抑郁症状的显著减轻相关，平均SMD为中度的-0.726（95%CI：-1.056，-0.396；Z=-4.57；P<0.001）。观察到显著的异质性（tau=0.408[95%CI：0.227，1.179]，I²=79.9%[95%CI：70.5%，86.3%]）。漏斗图显示存在潜在的发表偏倚。亚组分析表明，运动对抑郁的有益影响在所有亚组中均保持一致。证据质量被判定为“极低”确定性。
我们的系统评价和荟萃分析表明，运动干预与显著减轻抑郁症状相关（证据确定性：极低）。尽管证据的极低确定性凸显了进一步研究的必要性。
PROSPERO注册号：CRD42021248450。
