Intradialytic Exercise In Hemodialysis Patients-A Systematic Review And Meta-analysis

ObjectiveTo evaluate the efficacy and safety of intradialytic exercise for Hemodialysis patients.MethodsUp to February,2014, Medline, Embase and Cochrane Library were systematically searched for RCTs that studied with intradialytic exercise’s effects on HD patients. The reference lists of eligible RCTs and relevant reviews were also checked.ResultsTotally24RCTs of997patients were included. Compared with control, intradialytic exercise significantly improve HD patients’dialysis efficacy (Kt/V)(SMD=0.2795%CI0.01to0.53), peak oxygen consumption (VO2peak)(SMD=0.53,95%CI=0.30to0.76), and physical performance of physical function of life (SMD=0.3095%CI0.04to0.55). However, no significant improvements were found in mental function of life. There was no significant difference with respect to musculoskeletal and cardiovascular complications between the intradialytic exercise groups and control groups. Further subgroup analysis found that, when the trial duration was more than6months, the intervention had significant effects on VO2peak(SMD=0.89,95%CI=0.56to1.22). However, when the trial duration was less than6months, the change of VO2peak was not significant (SMD=0.19,95%CI=-0.13to0.51).ConclusionIntradialytic exercise can improve HD patients’Kt/V, VO2Peak and physical quality of life, and intradialytic exercise is safe for HD patients. Therefore, we suggest that intradialytic exercise should be implied in more dialysis centers.