Comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis: a systematic review and network meta-analysis
Network meta-analysis of 58 RCTs in adults on hemodialysis reported that aerobic exercise, respiratory muscle training, and combined resistance plus aerobic training improved six-minute walk distance versus usual care or sham, while resistance training alone was associated with lower C-reactive protein versus usual care.
Design
SR + frequentist NMA; 58 RCTs in maintenance hemodialysis; nine exercise nodes (RE, AE, EMS, ROM, RE+AE, stretching, RMT, PMT, walking, vs usual care/sham); outcomes included 6MWT, QoL, Kt/V, VO₂max, Hb, CRP, IL-6, BP.
Signals named in abstract
- 6MWT: AE, RMT, and RE+AE improved versus UC/SE; “SE” node described as worst for QoL
- VO₂max: higher with AE and RE+AE
- Hb: ROM and RE+AE associated with higher haemoglobin in network ranking narrative
- Inflammation / BP: activities did not raise BP, CRP, or IL-6 on average; RE associated with lower CRP; ROM associated with lower SBP/DBP in abstract summary
Evidence hygiene
End-stage kidney disease population on dialysis—external validity to healthy resistance-training hubs is limited even when modalities overlap.
Publication
Ren N, Song S, Li M, et al. Eur J Med Res. 2023 Oct 5;28(1):419. PMID 37798739.
Outcomes
- Network meta-analysis of 58 hemodialysis RCTs: aerobic training, respiratory muscle training, and combined resistance+aerobic training improved six-minute walk distance vs usual care/sham.
- Abstract: resistance exercise node associated with lower C-reactive protein vs usual care; ROM associated with lower clinic SBP/DBP; AE and RE+AE linked to higher VO2max—read network tables for exact MDs.