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Hargrove N, El Tobgy N, Zhou O, et al. Effect of Aerobic Exercise on Dialysis-Related Symptoms in Individuals Undergoing Maintenance Hemodialysis: A Systematic Review and Meta-Analysis of Clinical Trials. Clin J Am Soc Nephrol. 2021;16(4):560-574doi: 10.2215/CJN.15080920.
Hargrove, N., El Tobgy, N., Zhou, O., Pinder, M., Plant, B., Askin, N., Bieber, L., Collister, D., Whitlock, R., Tangri, N., & Bohm, C. (2021). Effect of Aerobic Exercise on Dialysis-Related Symptoms in Individuals Undergoing Maintenance Hemodialysis: A Systematic Review and Meta-Analysis of Clinical Trials. Clinical journal of the American Society of Nephrology : CJASN, 16(4), 560-574. https://doi.org/10.2215/CJN.15080920
Hargrove, Nicholas, et al. "Effect of Aerobic Exercise on Dialysis-Related Symptoms in Individuals Undergoing Maintenance Hemodialysis: A Systematic Review and Meta-Analysis of Clinical Trials." Clinical journal of the American Society of Nephrology : CJASN vol. 16,4 (2021): 560-574. doi: https://doi.org/10.2215/CJN.15080920
Hargrove N, El Tobgy N, Zhou O, Pinder M, Plant B, Askin N, Bieber L, Collister D, Whitlock R, Tangri N, Bohm C. Effect of Aerobic Exercise on Dialysis-Related Symptoms in Individuals Undergoing Maintenance Hemodialysis: A Systematic Review and Meta-Analysis of Clinical Trials. Clin J Am Soc Nephrol. 2021 Apr 07;16(4):560-574. doi: 10.2215/CJN.15080920. Epub 2021 Mar 25. PMID: 33766925; PMCID: PMC8092056.
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Clin J Am Soc Nephrol. 2021 Apr 07;16(4):560-574. doi: 10.2215/CJN.15080920. Epub 2021 Mar 25.

Effect of Aerobic Exercise on Dialysis-Related Symptoms in Individuals Undergoing Maintenance Hemodialysis: A Systematic Review and Meta-Analysis of Clinical Trials.

Clinical journal of the American Society of Nephrology : CJASN

Nicholas Hargrove, Nada El Tobgy, Olivia Zhou, Mark Pinder, Brittany Plant, Nicole Askin, Laura Bieber, David Collister, Reid Whitlock, Navdeep Tangri, Clara Bohm

Affiliations

  1. Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
  2. Chronic Disease Innovation Centre, Seven Oaks Hospital, Winnipeg, Manitoba, Canada.
  3. University of Manitoba Libraries, University of Manitoba, Winnipeg, Manitoba, Canada.
  4. Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
  5. Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada [email protected].

PMID: 33766925 PMCID: PMC8092056 DOI: 10.2215/CJN.15080920

Abstract

BACKGROUND: Hemodialysis is associated with a high symptom burden that impairs health-related quality of life and functional status. Effective symptom management is a priority for individuals receiving hemodialysis. Aerobic exercise may be an effective, nonpharmacologic treatment for specific hemodialysis-related symptoms. This systematic review investigated the effect of aerobic exercise on hemodialysis-related symptoms in adults with kidney failure undergoing maintenance hemodialysis.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We searched MEDLINE, PubMed, Cochrane CENTRAL, CINAHL, PsycINFO, SPORTDiscus, EMBASE, PEDro, and Scopus databases from 1960 or inception until April 15, 2020 for randomized controlled trials investigating the effect of aerobic exercise on hemodialysis-related symptoms, identified as prespecified primary or secondary outcomes, as compared with controls in adults on maintenance hemodialysis. We identified restless legs syndrome as the primary outcome.

RESULTS: Of 3048 studies identified, 15 randomized controlled trials met the eligibility criteria. These studies investigated the effect of aerobic exercise on restless legs syndrome (two studies), sleep disturbance (four studies), anxiety (four studies), depression (nine studies), muscle cramping (one study), and fatigue (one study). Exercise interventions were intradialytic in ten studies and outside of hemodialysis in five studies. Heterogenous interventions and outcomes and moderate to high risk of bias precluded meta-analysis for most symptoms. Aerobic exercise demonstrated improvement in symptoms of restless legs syndrome, muscle cramping, and fatigue, as compared with nonexercise controls. Meta-analysis of depressive symptoms in studies using the Beck Depression Inventory demonstrated a greater reduction in Beck Depression Inventory score with exercise as compared with control (mean difference -7.57; 95% confidence interval, -8.25 to -6.89).

CONCLUSIONS: Our review suggests that in adults on maintenance hemodialysis, aerobic exercise improves several hemodialysis-related symptoms, including restless legs syndrome, symptoms of depression, muscle cramping, and fatigue. However, the use of validated outcome measures with demonstrated reliability and responsiveness in more diverse hemodialysis populations is required to fully characterize the effect of this intervention.

CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: PROSPERO #CRD42017056658.

Copyright © 2021 by the American Society of Nephrology.

Keywords: aerobic exercise; dialysis-related symptoms; fatigue; hemodialysis; quality of life; restless legs syndrome

References

  1. Psychol Med. 2015 Nov;45(15):3269-79 - PubMed
  2. Front Physiol. 2017 May 31;8:288 - PubMed
  3. Psychiatry Res. 1989 May;28(2):193-213 - PubMed
  4. Nephrol Dial Transplant. 2018 Aug 1;33(8):1436-1445 - PubMed
  5. Hemodial Int. 2013 Jan;17(1):50-8 - PubMed
  6. Nephrol Dial Transplant. 1999 May;14(5):1163-70 - PubMed
  7. J Ren Care. 2013 Sep;39(3):140-50 - PubMed
  8. Br J Clin Psychol. 2010 Nov;49(Pt 4):507-16 - PubMed
  9. Am J Kidney Dis. 2018 Jul;72(1):104-112 - PubMed
  10. Iran J Kidney Dis. 2011 Mar;5(2):119-23 - PubMed
  11. Adv Chronic Kidney Dis. 2007 Jan;14(1):82-99 - PubMed
  12. J Am Soc Nephrol. 2004 Mar;15(3):743-53 - PubMed
  13. Clin J Am Soc Nephrol. 2019 Jan 7;14(1):150-160 - PubMed
  14. Kidney Int Suppl. 1983 Dec;16:S303-9 - PubMed
  15. Semin Dial. 2019 Jul;32(4):336-350 - PubMed
  16. Psychosom Med. 2000 Sep-Oct;62(5):633-8 - PubMed
  17. Am J Kidney Dis. 2003 Oct;42(4):713-21 - PubMed
  18. Am J Kidney Dis. 2017 Jan;69(1):97-107 - PubMed
  19. Nephrol Dial Transplant. 2020 Sep 1;35(9):1609-1618 - PubMed
  20. J Am Board Fam Med. 2006 Sep-Oct;19(5):487-93 - PubMed
  21. J Am Soc Nephrol. 2005 Aug;16(8):2487-94 - PubMed
  22. Nephrol Ther. 2009 Jun;5(3):193-200 - PubMed
  23. Am J Kidney Dis. 2017 Nov;70(5):638-655 - PubMed
  24. Nephrol Dial Transplant. 2005 Jan;20(1):141-6 - PubMed
  25. Am J Kidney Dis. 2005 Nov;46(5):919-24 - PubMed
  26. Am J Kidney Dis. 2005 May;45(5):912-6 - PubMed
  27. ScientificWorldJournal. 2013 Nov 06;2013:628142 - PubMed
  28. Nephron. 1997;77(2):152-8 - PubMed
  29. Clin J Am Soc Nephrol. 2014 Oct 7;9(10):1813-21 - PubMed
  30. Nephron. 1987;47(3):194-8 - PubMed
  31. Acupunct Med. 2009 Dec;27(4):163-8 - PubMed
  32. BMC Sports Sci Med Rehabil. 2020 Mar 18;12:19 - PubMed
  33. BMC Nephrol. 2013 Sep 11;14:194 - PubMed
  34. Clin Rehabil. 2009 Jan;23(1):53-63 - PubMed
  35. Cochrane Database Syst Rev. 2011 Oct 05;(10):CD003236 - PubMed
  36. Eur J Cardiovasc Prev Rehabil. 2010 Apr;17(2):160-7 - PubMed
  37. Clin J Am Soc Nephrol. 2017 Feb 7;12(2):298-303 - PubMed
  38. Sleep. 1991 Dec;14(6):540-5 - PubMed
  39. J Pain Symptom Manage. 2018 Apr;55(4):1184-1195 - PubMed
  40. Health Qual Life Outcomes. 2008 Jul 02;6:46 - PubMed
  41. Int Urol Nephrol. 2018 Apr;50(4):745-754 - PubMed
  42. Clin Rehabil. 2019 Feb;33(2):147-156 - PubMed
  43. Sleep Med. 2013 Nov;14(11):1229 - PubMed

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