■运动疗法可以有效管理慢性肾脏病(CKD)危险因素,改善肾功能和身体素质,但挑战在于选择适合患者病情的正确运动类型。
■对包括PubMed在内的数据库进行电子搜索,科克伦图书馆,EMBASE,WebofScience,VIP,万方,并执行了CNKI。使用随机效应模型。平均差被用作连续变量的效应大小,提供95%置信区间(CI)。
■本研究共纳入36项随机对照试验。与常规治疗(CT)相比,三种运动疗法与CT的结合在增强六分钟步行测试(6MWT)能力方面产生了显着的益处,24小时尿蛋白量(24hUTP),收缩压(SBP),舒张压(DBP)。抗阻运动疗法(RT)+CT比CT更有效地降低血肌酐(Scr),体重指数(BMI),和血红蛋白A1c(HbA1c)和改善估计的肾小球滤过率(eGFR)。在提高峰值摄氧量(VO2峰值)方面,只涉及两种锻炼方式,有氧运动疗法(AT)和联合(阻力-有氧)运动疗法(CBT),两者都比CT更有效。总体疗效排名显示,RT在增强eGFR和6MWT方面具有明显的益处,减少Scr,BMI,SBP,DBP,和HbA1c,虽然AT更适合提高VO2峰值,CBT具有降低24hUTP的更大潜力。
■运动疗法结合CT在许多情况下具有明显的优势,但是没有一种运动方式对所有指标都是普遍有效的。
UNASSIGNED: Exercise therapy can effectively manage chronic kidney disease (CKD) risk factors and improve renal function and physical fitness, but the challenge lies in choosing the right exercise type tailored to patients\' condition.
UNASSIGNED: An electronic search of databases including PubMed, The Cochrane Library, EMBASE, Web of Science, VIP, WanFang, and CNKI was performed. The random effects model was used. Mean difference was employed as the effect size for continuous variables, with 95% confidence interval (CI) provided.
UNASSIGNED: A total of 36 RCTs were included in this study. Compared to conventional therapy (CT), the combination of three exercise therapies with CT resulted in notable benefits in enhancing six minutes walk test (6MWT) capacity, 24-h urinary protein quantity (24hUTP), systolic blood pressure (SBP), diastolic blood pressure (DBP). Resistance exercise therapy (RT) + CT were more effective than CT to reduce serum creatinine (Scr), body mass index (BMI), and hemoglobin A1c (HbA1c) and improve estimated glomerular filtration rate (eGFR). In terms of improving peak oxygen uptake (VO2 peak), only two exercise modalities were involved, aerobic exercise therapy (AT) and combined (Resistance-Aerobic) exercise therapy (CBT), both of which were more efficacious than CT. The efficacy ranking overall demonstrated clear benefits for RT in enhancing eGFR and 6MWT, decreasing Scr, BMI, SBP, DBP, and HbA1c, while AT was more suitable for boosting VO2 peak, and CBT had greater potential for reducing 24hUTP.
UNASSIGNED: Exercise therapy combined with CT offers significant advantages over CT in many cases, but no single exercise modality is universally effective for all indicators.