Effects of combined aerobic and resistance exercise on renal function in adult patients with chronic kidney disease: a systematic review and meta-analysis
Abstract
Objectives:
Combined aerobic and resistance exercise (CARE) is beneficial for improving renal function. To confirm this, we conducted a meta-analysis to evaluate the effects of CARE on renal function in adult patients with chronic kidney disease (CKD).
Date sources:
The last date of search was 22 February 2020. We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Allied and Complementary Medicine (AMED), CINAHL, Web of Science, SPORTDiscus, and three Chinese databases (China National Knowledge Infrastructure (CNKI), Wangfang, Journal Integration Platform (VIP)) for articles of randomized and quasi-randomized controlled trials.
Methods:
We used the Cochrane tool and the JBI Critical Appraisal checklist to assess randomized controlled trials and quasi-randomized controlled trials, respectively.
Result:
A total of 12 studies and 745 patients were included. Compared with usual care or no exercise, CARE resulted in a significant improvement in the estimated glomerular filtration rate (between-group analysis: mean difference (MD) =5.01, 95% confidence interval (CI): 2.37 to 7.65; within-group analysis: MD = 3.01, 95% CI: 0.86 to 5.16). The serum creatinine levels also showed a significant improvement after CARE (between-group analysis: MD = −8.57, 95% CI: −13.71 to −3.43; within-group analysis: MD = −6.33, 95% CI: −10.23 to −2.44). Patients who performed CARE also demonstrated a decline in the blood pressure in the within-group analysis (systolic blood pressure: MD = −5.24, 95% CI: −7.93 to −2.54; diastolic blood pressure: MD = −3.63, 95% CI: −5.35 to −1.91). However, there were no significant differences in proteinuria, lipid levels, physical composition, and quality of life.
Conclusion:
The study results support the concept that CARE intervention improves renal function. It provides strong evidence for guiding clinical decisions and implementing renal rehabilitation exercises.
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Published In
Article first published online: June 8, 2020
Issue published: July 2020
Keywords
PubMed: 32513020
Authors
Authors’ contribution
X.X.W. and L.Y. contributed equally to this work. R.H. was responsible for the study conception and design. X.X.W. and L.Y. contributed to data acquisition, analysis, and interpretation. X.X.W. was responsible for manuscript preparation. R.H. and Y.W. contributed to the critical revision of the manuscript, obtained funding, and supervised the research. Y.W. and C.F.W. contributed to the review of the data and manuscript. All authors approved the final manuscript and have participated sufficiently in the work to take public responsibility for appropriate portions of the content.
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