Smart, Neil; McFarlane, James; Cornelissen, Veronique

Author(s)

Smart, Neil

McFarlane, James

Cornelissen, Veronique

Publication Date

2013

Abstract

Background: Patients undergoing dialysis have high mortality rates and a unique risk factor profile. Some improvements elicited by exercise training have been shown in dialysis populations, here we aimed to further explore the benefits of exercise. As well as changes in physical fitness we quantified cardiac function, depression, serum biochemistry, dialysis adequacy and energy intake following exercise training in people with chronic kidney disease (CKD) undertaking dialysis. Methods: A systematic literature search was completed in December 2012 identifying randomized, controlled trials of exercise training studies in haemodialysis (HD) patients. A subsequent meta-analysis was conducted. Results: Twenty four studies were included, totalling 879 patients. Exercise training produced significant improvements in physical fitness: peak VO₂ 5.03 mlO₂·kg⁻¹·min⁻¹ (95% CI 3.73, 6.33, p < 0.0001), Knee extensor strength 2.99 kg (95% CI 0.46, 5.52, p = 0.02) and 6 minute walk distance 60.7 metres (95% CI 18.9, 103, p = 0.004). Significant increases in energy intake MD 238 Kcal·day⁻¹ (95% CI 94, 383, p = 0.001), serum Interleukin-6 MD-0.58 pg·ml⁻¹ (95% CI-1.01, -0.15, p = 0.008) and C-reactive protein MD 0.92 mg/L⁻¹ (95% CI 0.29, 1.56, p = 0.004), but not Albumin or BMI, were reported. Improved Beck Depression scores were reported MD-6.9 (95% CI-9.7,-4.1, p < 0.00001). Dialysis adequacy was reduced MD-0.23 (95% CI -0.29, -0.17, p < 0.00001), while serum potassium was higher MD 0.14 mmol·L⁻¹ (95% CI 0.01, 0.27, p = 0.04). Moreover exercise training appeared safe, with no direct exercise-associated deaths in over 30,000 patient-hours. Conclusions: Our pooled analyses confirmed improvements in physical fitness following exercise training and suggested additional improvements in dialysis efficiency (kt/v), serum potassium, inflammation and depression in HD patients.

Citation

Open Journal of Nephrology, 3(1), p. 25-36

ISSN

2164-2869

2164-2842

Link

https://hdl.handle.net/1959.11/14264

Publisher

Scientific Research Publishing, Inc

Title

The Effect of Exercise Therapy on Physical Function, Biochemistry and Dialysis Adequacy in Haemodialysis Patients: A Systematic Review and Meta-Analysis

Type of document

Journal Article

Entity Type

Publication

Author(s)	Smart, Neil McFarlane, James Cornelissen, Veronique
Publication Date	2013
Abstract	Background: Patients undergoing dialysis have high mortality rates and a unique risk factor profile. Some improvements elicited by exercise training have been shown in dialysis populations, here we aimed to further explore the benefits of exercise. As well as changes in physical fitness we quantified cardiac function, depression, serum biochemistry, dialysis adequacy and energy intake following exercise training in people with chronic kidney disease (CKD) undertaking dialysis. Methods: A systematic literature search was completed in December 2012 identifying randomized, controlled trials of exercise training studies in haemodialysis (HD) patients. A subsequent meta-analysis was conducted. Results: Twenty four studies were included, totalling 879 patients. Exercise training produced significant improvements in physical fitness: peak VO₂ 5.03 mlO₂·kg⁻¹·min⁻¹ (95% CI 3.73, 6.33, p < 0.0001), Knee extensor strength 2.99 kg (95% CI 0.46, 5.52, p = 0.02) and 6 minute walk distance 60.7 metres (95% CI 18.9, 103, p = 0.004). Significant increases in energy intake MD 238 Kcal·day⁻¹ (95% CI 94, 383, p = 0.001), serum Interleukin-6 MD-0.58 pg·ml⁻¹ (95% CI-1.01, -0.15, p = 0.008) and C-reactive protein MD 0.92 mg/L⁻¹ (95% CI 0.29, 1.56, p = 0.004), but not Albumin or BMI, were reported. Improved Beck Depression scores were reported MD-6.9 (95% CI-9.7,-4.1, p < 0.00001). Dialysis adequacy was reduced MD-0.23 (95% CI -0.29, -0.17, p < 0.00001), while serum potassium was higher MD 0.14 mmol·L⁻¹ (95% CI 0.01, 0.27, p = 0.04). Moreover exercise training appeared safe, with no direct exercise-associated deaths in over 30,000 patient-hours. Conclusions: Our pooled analyses confirmed improvements in physical fitness following exercise training and suggested additional improvements in dialysis efficiency (kt/v), serum potassium, inflammation and depression in HD patients.
Citation	Open Journal of Nephrology, 3(1), p. 25-36
ISSN	2164-2869 2164-2842
Link	https://hdl.handle.net/1959.11/14264
Publisher	Scientific Research Publishing, Inc
Title	The Effect of Exercise Therapy on Physical Function, Biochemistry and Dialysis Adequacy in Haemodialysis Patients: A Systematic Review and Meta-Analysis
Type of document	Journal Article
Entity Type	Publication

The Effect of Exercise Therapy on Physical Function, Biochemistry and Dialysis Adequacy in Haemodialysis Patients: A Systematic Review and Meta-Analysis

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