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Does intradialytic exercise improve removal of solutes by hemodialysis? A systematic review and meta-analysis |
Ferreira GD, Bohlke M, Correa CM, Dias EC, Orcy RB |
Archives of Physical Medicine and Rehabilitation 2019 Dec;100(12):2371-2380 |
systematic review |
OBJECTIVE: To describe a systematic review and meta-analysis to identify if intradialytic exercise improves the removal of solutes and the hemodialysis adequacy. DATA SOURCES: A systematic review and meta-analysis of randomized controlled trials (RCT) was performed. The sources were Medline (via PubMed), Web of Science, LILACS and SciELO, from inception until July 2018. STUDY SELECTION: Clinical trials including patients on chronic hemodialysis submitted to the intervention of aerobic intradialytic exercise. DATA EXTRACTION: Evaluating as outcomes the removal of solutes (creatinine, phosphate and potassium) and/or adequacy parameters (Kt/V-urea). DATA SYNTHESIS: The systematic review included 23 studies (seven evaluating the effect of one exercise session and 16 evaluating the effect of training, lasting from 6 to 25 weeks). Eleven RCT were included in the meta-analyses. It was observed that the aerobic intradialytic exercise increased the Kt/V-urea (0.15, 95% CI 0.08 to 0.21) and decreased creatinine (-1.82 mg/dL, 95% CI -2.50 to -1.13), despite the high heterogeneity of the analysis. No differences were found in phosphorus and potassium removal. CONCLUSION: the aerobic intradialytic exercise may be suggested to improve the Kt/V-urea and the creatinine removal during the dialysis.
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