Effects of intradialytic exercise on cardiopulmonary capacity in chronic kidney disease: systematic review and meta-analysis of randomized clinical trials

Francini Porcher Andrade, Patrícia de Souza Rezende, Tatiane de Souza Ferreira, Gabrielle Costa Borba, Alice Mânica Müller, Paula Maria Eidt Rovedder, Francini Porcher Andrade, Patrícia de Souza Rezende, Tatiane de Souza Ferreira, Gabrielle Costa Borba, Alice Mânica Müller, Paula Maria Eidt Rovedder

Abstract

Patients with chronic kidney disease show poorer functional and cardiorespiratory capacity than healthy individuals, and these impairments result in sedentarism. The aim of this study was to conduct a systematic review and meta-analysis of randomized clinical trials on the effects of different intradialytic exercise protocols on cardiopulmonary capacity in chronic kidney disease patients. The primary outcome was peak oxygen consumption (VO2peak) and the secondary outcomes were exercise duration and ventilation in the cardiopulmonary test. The quality of the evidence was evaluated using the GRADE guidelines. Seven studies with a total of 124 participants met the inclusion criteria. Compared to the non-exercise group, the exercise group improved in mean VO2peak (MD 4.06 [IC 0.81; 7.31]). In a separate analysis according to exercise modality, aerobic exercise plus strength training performed better than aerobic exercise alone (MD 5.28 [IC 3.90; 6.66]). In the exercise group, both exercise tolerance values (MD 3.10 [IC 1.70; 4.51]) and ventilation values in the cardiopulmonary test were better than those of the control group (MD 13.10 [IC 7.12; 19.09]). Thus, intradialytic exercise protocols can improve cardiopulmonary function, exercise tolerance and ventilatory efficiency in chronic kidney disease patients.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study selection flowchart.
Figure 2
Figure 2
Difference in VO2peak mL/kg/min between pre- and post-intervention.
Figure 3
Figure 3
Difference in VO2peak mL/kg/min between intervention and control groups in patients who performed aerobic exercise alone.
Figure 4
Figure 4
Difference in VO2peak mL/kg/min between intervention and control groups in patients who performed aerobic exercise and strength training.
Figure 5
Figure 5
Difference in cardiopulmonary test duration (in minutes) between intervention and control groups.
Figure 6
Figure 6
Difference in ventilation between pre- and post-intervention or between intervention and control groups.

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