Exercise training for adults with chronic kidney disease

摘要: Background Chronic kidney disease (CKD) is a worldwide public health problem. In the National Kidney Foundation Disease Outcomes Quality Initiative guidelines it stressed that lifestyle issues such as physical activity should be seen cornerstones of therapy. The fitness in adults with CKD so reduced impinges on ability and capacity to perform activities everyday life occupational tasks. An increasing number studies have been published regarding effects various regular exercise programmes renal transplant patients. Objectives We aimed to: 1) assess patients; 2) determine how programme designed (e.g. type, duration, intensity, frequency exercise) able affect functioning, level activity, cardiovascular dimensions, nutrition, lipids, glucose metabolism, systemic inflammation, muscle morphology morphometrics, dropout rates, compliance, adverse events mortality. Search methods We searched Cochrane Renal Group's specialised register, CENTRAL, MEDLINE, EMBASE, CINAHL, Web Science, Biosis, Pedro, Amed, AgeLine, PsycINFO KoreaMed. We also handsearched reference lists review articles included studies, conference proceeding's abstracts. There were no language restrictions. Date last search: May 2010. Selection criteria We any randomised controlled trial (RCT) enrolling or recipients undergoing type intervention undertaken for eight weeks more. Studies using less than exercise, those only recommending an increase which co-interventions are not applied given both groups excluded. Data collection analysis Data extraction assessment study data quality performed independently by two authors. Continuous outcome presented standardised mean difference (SMD) (MD) 95% confidence intervals (CI). Main results Forty-five randomising 1863 participants this review. Thirty could meta-analysed. Types training training, mixed resistance resistance-only yoga. Some used supervised interventions others unsupervised interventions. Exercise intensity was classed 'high' 'low', duration individual sessions ranged from 20 minutes/session 110 minutes/session, 18 months. Seventeen per cent having overall low risk bias, 33% moderate, 49% high bias. The results shows significantly improved: (aerobic capacity, 24 847 participants: SMD -0.56, CI -0.70 -0.42; walking 7 191 -0.36, CI-0.65 -0.06); dimensions (resting diastolic blood pressure, 11 419 MD 2.32 mm Hg, 0.59 4.05; resting systolic 9 347 6.08 2.15 10.12; heart rate, 229 6 bpm, 10 2); 3) some nutritional parameters (albumin, 3 111 -2.28 g/L, -4.25 -0.32; pre-albumin, - 44.02 mg/L, -71.52 -16.53; energy intake, 4 97 -0.47, -0.88 -0.05); 4) health-related life. Results showed order optimise effect. Other outcomes had insufficient evidence. Authors' conclusions There evidence significant beneficial fitness, pressure rate), CKD. due lack RCTs. design causes effect size considered when prescribing aim affecting certain outcome. Future RCTs focus more cardiovascular- these types studied much exercise.