Systematic Review of the Best Evidence for Resistance Exercise in Maintenance Hemodialysis Patients

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2025 Jan 8

PMID 39775055

Authors

Qian Zhao

Ning Wu

Kaixing Duan

Jiahui Liu

Minghua Han

Huize Xu

Haoyang Chen

Ji Ma

Affiliations

Soon will be listed here.

Abstract

Objective: This study aims to search, evaluate, and consolidate the best evidence for resistance exercise in maintenance hemodialysis patients, providing evidence-based support for the clinical implementation of resistance exercise in these patients.

Methods: We conducted a comprehensive search of literature in databases on resistance exercise for maintenance hemodialysis patients, including guidelines, expert consensus, evidence summaries, systematic reviews, and randomized controlled trials. The search spanned from the inception of the database to March 2023. During the process of evaluation and data extraction, two researchers rigorously assessed the quality of the literature.

Results: A total of 24 articles were included in this review, consisting of 2 guidelines, 3 expert consensus documents, 9 systematic reviews, and 10 randomized controlled trials. From nine aspects, including target population, contraindications for exercise, pre-exercise assessment, exercise frequency, exercise intensity, exercise duration, exercise type, exercise benefits, and exercise precautions, we extracted a total of 23 pieces of best evidence.

Conclusion: Given the findings of this study, we recommend that future researchers design and conduct larger-scale, multi-center, longitudinal studies to validate our results and further explore the long-term impacts of combined resistance and aerobic exercises on muscle strength and other health indicators. Such research will provide deeper insights and contribute to the development of evidence-based exercise programs.

References

Lu Y, Wang Y, Lu Q . Effects of Exercise on Muscle Fitness in Dialysis Patients: A Systematic Review and Meta-Analysis. Am J Nephrol. 2019; 50(4):291-302. DOI: 10.1159/000502635. View

Zhang F, Huang L, Wang W, Shen Q, Zhang H . Effect of intradialytic progressive resistance exercise on physical fitness and quality of life in maintenance haemodialysis patients. Nurs Open. 2020; 7(6):1945-1953. PMC: 7544880. DOI: 10.1002/nop2.585. View

Pellizzaro C, Thome F, Veronese F . Effect of peripheral and respiratory muscle training on the functional capacity of hemodialysis patients. Ren Fail. 2012; 35(2):189-97. DOI: 10.3109/0886022X.2012.745727. View

Koufaki P, Greenwood S, Painter P, Mercer T . The BASES expert statement on exercise therapy for people with chronic kidney disease. J Sports Sci. 2015; 33(18):1902-7. DOI: 10.1080/02640414.2015.1017733. View

Andrade F, de Souza Rezende P, de Souza Ferreira T, Borba G, Muller A, Rovedder P . Effects of intradialytic exercise on cardiopulmonary capacity in chronic kidney disease: systematic review and meta-analysis of randomized clinical trials. Sci Rep. 2019; 9(1):18470. PMC: 6895108. DOI: 10.1038/s41598-019-54953-x. View

Cardoso D, Leal D, Martins P, Abade E, Rocha H, Ferreira M . Novel Approach to Intradialytic Progressive Resistance Exercise Training. Blood Purif. 2023; 52(9-10):768-774. DOI: 10.1159/000531973. View

Himmelfarb J, Vanholder R, Mehrotra R, Tonelli M . The current and future landscape of dialysis. Nat Rev Nephrol. 2020; 16(10):573-585. PMC: 7391926. DOI: 10.1038/s41581-020-0315-4. View

Zhao Q, Zhang H, Wen X, Wang Y, Chen X, Chen N . Exercise interventions on patients with end-stage renal disease: a systematic review. Clin Rehabil. 2019; 33(2):147-156. DOI: 10.1177/0269215518817083. View

Fernandez-Martin J, Martinez-Camblor P, Dionisi M, Floege J, Ketteler M, London G . Improvement of mineral and bone metabolism markers is associated with better survival in haemodialysis patients: the COSMOS study. Nephrol Dial Transplant. 2015; 30(9):1542-51. DOI: 10.1093/ndt/gfv099. View

10.

Gomes Neto M, Lacerda F, Lopes A, Prata Martinez B, Saquetto M . Intradialytic exercise training modalities on physical functioning and health-related quality of life in patients undergoing maintenance hemodialysis: systematic review and meta-analysis. Clin Rehabil. 2018; 32(9):1189-1202. DOI: 10.1177/0269215518760380. View

11.

Cheng L, Jiang Y, Wu V, Wang W . A systematic review and meta-analysis: Vinegar consumption on glycaemic control in adults with type 2 diabetes mellitus. J Adv Nurs. 2019; 76(2):459-474. DOI: 10.1111/jan.14255. View

12.

Cigarroa I, Barriga R, Micheas C, Zapata-Lamana R, Soto C, Manukian T . [Effects of a resistance training program in patients with chronic kidney disease on hemodialysis]. Rev Med Chil. 2016; 144(7):844-52. DOI: 10.4067/S0034-98872016000700004. View

13.

Regolisti G, Maggiore U, Sabatino A, Gandolfini I, Pioli S, Torino C . Interaction of healthcare staff's attitude with barriers to physical activity in hemodialysis patients: A quantitative assessment. PLoS One. 2018; 13(4):e0196313. PMC: 5922547. DOI: 10.1371/journal.pone.0196313. View

14.

Frih B, Jaafar H, Mkacher W, Salah Z, Hammami M, Frih A . The Effect of Interdialytic Combined Resistance and Aerobic Exercise Training on Health Related Outcomes in Chronic Hemodialysis Patients: The Tunisian Randomized Controlled Study. Front Physiol. 2017; 8:288. PMC: 5449721. DOI: 10.3389/fphys.2017.00288. View

15.

Ribeiro R, Coutinho G, Iuras A, Barbosa A, Souza J, Diniz D . [Effect of resistance exercise intradialytic in renal patients chronic in hemodialysis]. J Bras Nefrol. 2013; 35(1):13-9. DOI: 10.5935/01012800.20130003. View

16.

Barker T, Stone J, Sears K, Klugar M, Tufanaru C, Leonardi-Bee J . The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials. JBI Evid Synth. 2023; 21(3):494-506. DOI: 10.11124/JBIES-22-00430. View

17.

Cheema B, Abas H, Smith B, OSullivan A, Chan M, Patwardhan A . Progressive exercise for anabolism in kidney disease (PEAK): a randomized, controlled trial of resistance training during hemodialysis. J Am Soc Nephrol. 2007; 18(5):1594-601. DOI: 10.1681/ASN.2006121329. View

18.

Baker L, March D, Wilkinson T, Billany R, Bishop N, Castle E . Clinical practice guideline exercise and lifestyle in chronic kidney disease. BMC Nephrol. 2022; 23(1):75. PMC: 8862368. DOI: 10.1186/s12882-021-02618-1. View

19.

Clarke A, Young H, Hull K, Hudson N, Burton J, Smith A . Motivations and barriers to exercise in chronic kidney disease: a qualitative study. Nephrol Dial Transplant. 2015; 30(11):1885-92. DOI: 10.1093/ndt/gfv208. View

20.

Johansen K, Painter P, Sakkas G, Gordon P, Doyle J, Shubert T . Effects of resistance exercise training and nandrolone decanoate on body composition and muscle function among patients who receive hemodialysis: A randomized, controlled trial. J Am Soc Nephrol. 2006; 17(8):2307-14. DOI: 10.1681/ASN.2006010034. View