Systematic Review and Meta-analysis of Exercise Tolerance and Physical Functioning in Dialysis Patients Treated With Erythropoiesis-Stimulating Agents

摘要: Background The role of erythropoiesis-stimulating agents (ESAs) in treating the anemia chronic kidney disease has been reevaluated view recent studies suggesting that use these may be associated with increased morbidity and mortality. This potential risk needs to weighed against benefit ESAs improving various aspects health-related quality life, particular, exercise tolerance physical functioning. Study Design A systematic review meta-analysis Setting & Participants Adults on maintenance dialysis therapy. Selection Criteria for Studies Outcomes measured before after ESA treatment were required. function required include at least 25 participants. Intervention Treatment any ESA. Exercise using VO 2peak (oxygen consumption per minute peak workload during test), duration exercise, or 6-minute walk distance functioning assessed ≥ 1 patient- clinician-reported outcome measure included a domain. Results 28 articles met criteria inclusion evaluation tolerance, 14 articles, function. Meta-analysis showed 23.8% increase from erythropoietin therapy initiation (15 studies) nonsignificant 8.2% comparing higher lower hemoglobin target (3 studies). For functioning, 4 meta-analysis: there was 10.5% Karnofsky score initiation. Limitations Many did not control groups. wide variety instruments used assess Conclusions Partial correction through consistent positive impact . improves clinician-assessed