Effect of exercise training on reducing cardiovascular risk in patients with CKD: a systematic review and meta-analysis

ID: 

70

Session: 

Poster session 1

Date: 

Monday 24 October 2016 - 10:30 to 11:00

Location: 

All authors in correct order:

Qin X1, Xia J2, Liang J2, Wu Y1, Su G3, Zhang L1, Liu X1
1 Nephrology Department, The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, China
2 The Second Clinical Medical College, Guangzhou University of Chinese Medicine, China
3 Global Health – Health Systems and Policy: Medicines, focusing on antibiotics, Department of Public Health Sciences, Karolinska Institutet, Sweden
Presenting author and contact person

Presenting author:

Xindong Qin

Contact person:

Abstract text
Background: Inadequate physical activity is related to impaired cardiovascular reserve capacity and higher mortality in early years. While cardiovascular disease (CVD) is the leading cause of death in chronic kidney disease (CKD) populations, the effect of regular exercise on this group is unclear.

Objectives: To assess the effects and safety of regular exercise in non-dialysis CKD populations with regard to physical fitness, cardiovascular and renal outcomes.

Methods: We searched for randomized controlled trials (RCTs) that addressed the effects of regular exercise in non-dialysis CKD patients in CENTRAL, Embase, PubMed, Web of Science, and four Chinese databases (CBM, CNKI, CQVIP, WANFANG), up to June 2015. Study selection, data extraction and scientific quality assessment were performed independently by two researchers. Continuous outcome data were presented as mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI).

Results: We identified 14 RCTs with 473 participants. Types of exercise included aerobic, mixed and resistance training. Most studies exercised three times per week at moderate intensity, for 20-60 minutes per session, over 3-18 months. Thirty-six per cent of studies were classified as being at low risk of bias, another 36% as being at unclear risk, and 28% as high risk. Regular exercise showed benefits in cardiovascular function (mean blood pressure, 1 RCT, 27 participants: MD -7.99 mmHg, 95% CI -11.41 to -4.56; pulse wave velocity, 1 RCT, 18 participants: MD -2.6 m/s, 95% CI -4.46 to -0.74) and physical fitness (aerobic capacity, 10 RCTs, 249 participants: MD 2.29 mL/kg/min, 95% CI 1.18 to 3.39; walking capacity, 4 RCTs, 128 participants: MD 31.89 m, 95% CI 8.02 to 55.77; muscular strength, 1 RCT, 26 participants: MD 121 kg, 95% CI 78.74 to 163.26). There was insufficient evidence on outcomes of kidney function (glomerular filtration rate and serum creatinine). None of trials reported the incidence of CVD and mortality.

Conclusions: Regular exercise may reduce cardiovascular risks by improving cardiovascular function and fitness. Effect on long-term outcomes needs to be tested by future studies.