Intradialytic training in patients with end-stage renal disease: a systematic review and meta-analysis of randomized clinical trials assessing the effects of five different training interventions

Ferrari, Filipe; Helal, Lucas; Dipp, Thiago; Soares, Douglas dos Santos; Soldatelli, Angela; Mills, Drew; Paz, Cláudio Luiz da Silva Lima; Tenório, Mário César Carvalho; Motta, Marcelo Trotte; Barcellos, Franklin Corrêa; Stein, Ricardo

doi:10.1007/s40620-019-00687-y

Cited by 46 publications

(66 citation statements)

References 78 publications

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“…The impact of a moderate to high level of PA on mortality has been suggested to be the result of the positive effects on classic cardiovascular risk factors. Indeed, previous studies on patients undergoing HD have suggested that PA had a positive effect on, for example, blood pressure [18], glucose tolerance [19], CRP [20], heart rate variability [21], and visceral fat [22]. As cardiovascular mortality is frequent in patients with CKD, the aforementioned mechanisms may explain the association between PA and a reduced mortality in this and previous studies.…”

Section: Discussionsupporting

confidence: 59%

Sex Difference in the Association between Physical Activity and All-Cause Mortality in Ambulatory Patients with Chronic Kidney Disease

Mølsted

Eidemak²,

Aadahl

2021

IJERPH

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(1) Background: The purpose of this article was to investigate the association between self-reported physical activity (PA) and all-cause mortality in ambulatory patients with chronic kidney disease (CKD), stage 4–5 including maintenance dialysis. (2) Methods: Ambulatory patients with CKD (eGFR < 30 mL/min/1.73 m2) with conservative treatment or chronic dialysis were included. PA was assessed using the Saltin–Grimby Physical Activity Level Scale. A Cox proportional hazards regression model––adjusted for age, sex, plasma–albumin, body mass index, socioeconomic status, and treatment––was applied. (3) Results: Participants (n = 374) were followed 39 ± 15 months from entry to death or censoring. Throughout the study period of 39 months, 156 deaths (42%) were registered. Regarding physical activity, 128 (34%) of the participants were inactive, 212 (57%) were moderately active, and 34 (9%) were highly or vigorously active. Moderate PA was associated with a decreased mortality risk in women (n = 150) compared to inactivity (HR 0.27 (0.15; 0.51), p < 0.001), whereas a high/vigorous level of PA was not significantly associated with mortality risk compared to inactivity. In men (n = 224), the associations between PA levels and mortality risk were not significant. (4) Conclusions: Moderate PA was associated with reduced all-cause mortality in ambulatory women with stage 4–5 CKD with or without maintenance dialysis treatment. Physical activity was not significantly associated with mortality in men.

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Section: Discussionsupporting

confidence: 59%

Sex Difference in the Association between Physical Activity and All-Cause Mortality in Ambulatory Patients with Chronic Kidney Disease

Mølsted

Eidemak²,

Aadahl

2021

IJERPH

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“…Moreover, two recently published studies in which performance status [ 86 ] and strength [ 87 ] were examined concluded that the heterogeneity and the indistinct bias of the existing studies cannot lead to general conclusions [ 86 , 87 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Exercise on Nutritional Status and Body Composition in Hemodialysis: A Systematic Review

et al. 2020

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Chronic kidney disease (CKD) is associated with aggravating factors which can affect both body composition and nutritional status. The purpose of the present systematic review was to investigate the potential effects of any physical activity on body composition or nutritional status among patients with stage 5 CKD undergoing hemodialysis (HD). A literature search on PubMed, Scopus, Web of Science, Google Scholar, and Cochrane was conducted and 14 randomized clinical trials were included. Skeletal muscle index and mid-arm muscular circumference increased after resistance exercise, and the results on body mass index, % body fat, and lean body mass varied. Serum albumin and C-reactive protein, in most cases, showed a slight increase and decrease, respectively. An improvement was also observed in body strength and overall performance status. The results suggest that physical activity can be beneficial for both the body composition and nutritional status of patients undergoing HD and can help in the prevention of sarcopenia. However, further research is needed mainly in the field of nutritional status.

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“…Based on the significant correlation between poor physical performance and high mortality in CKD patients, several prospective trials and metanalysis have assessed whether exersice intervention could improve patient outcomes [38][39][40][41][42][43][44][45]. Although physical training significantly improved patient quality of life and inflammatory parameters in most studies, these benefits were not translated into better patient survival.…”

Section: Discussionmentioning

confidence: 99%

Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patient

Lee

Kim

Jung

et al. 2020

Preprint

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Background Low physical performance in patients undergoing maintenance hemodialysis is associated with a high mortality rate. We investigated the clinical relevance of gait speed and handgrip strength, the two most commonly used methods of assessing physical performance.Methods We obtained data regarding gait speed and handgrip strength from 277 hemodialysis patients and evaluated their relationships with baseline parameters, mental health, plasma inflammatory markers, and major adverse clinical outcomes. Low physical performance was defined by the recommendations suggested by the Asian Working Group on Sarcopenia.Results The prevalence of low gait speed and handgrip strength was 28.2% and 44.8%, respectively. Old age, low serum albumin levels, high comorbidity index score, and impaired cognitive functions were associated with low physical performance. Patients with isolated low gait speed exhibited a general trend for worse quality of life than those with isolated low handgrip strength. Gait speed and handgrip strength showed very weak correlations with different determining factors (older age, the presence of diabetes, and lower serum albumin level for low gait speed, and lower body mass index and the presence of previous cardiovascular events for low handgrip strength). Patients with low gait speed and handgrip strength had elevated levels of plasma endocan and matrix metalloproteinase-7 and the highest risks for all-cause mortality and cardiovascular events among the groups (adjusted hazard ratio of 2.72, p = 0.024). Elderly patients with low gait speed and handgrip strength were at the highest risk for poor clinical outcomes.Conclusion Gait speed and handgrip strength reflected distinctive aspects of patient characteristics and the use of both factors improved the prediction of adverse clinical outcomes in hemodialysis patients. Gait speed seems to be a better indicator of poor patient outcomes than is handgrip strength.

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Intradialytic training in patients with end-stage renal disease: a systematic review and meta-analysis of randomized clinical trials assessing the effects of five different training interventions

Cited by 46 publications

References 78 publications

Sex Difference in the Association between Physical Activity and All-Cause Mortality in Ambulatory Patients with Chronic Kidney Disease

Sex Difference in the Association between Physical Activity and All-Cause Mortality in Ambulatory Patients with Chronic Kidney Disease

The Effect of Exercise on Nutritional Status and Body Composition in Hemodialysis: A Systematic Review

Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patient

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