EFFECTIVENESS OF INTRADIALYTIC EXERCISES ON HEMODIALYSIS OUTCOMES: A META-ANALYSIS

Abstract

Introduction:

Chronic kidney disease (CKD) has emerged as a prominent global health concern with prevalence rate ranging from 9.1% to 13.4% worldwide and 12.5% to 31.5% in Pakistan. Exercise in Hemodialysis (HD) has made significant progress in the last couple of years including resistance exercises (RE), aerobic exercises (AE) and combination exercise (CE) but still numerous questions are still unanswered.

Objective:

To determine the effectiveness of Intradialytic exercises (IDE) on HD outcomes.

Methods:

This meta-analysis was done as per PRISMA and PEDro guidelines. Data based searching was done after extraction of literature through PubMed, Embrace, and Cochrane. The methodological quality of the eligible studies was assessed. Outcome measures include Dialysis adequacy (KT/V) with a reliability of 0.98, Body mass index (BMI) with a reliability of 0.95 and HD duration

Result:

The meta-analysis of six Randomized controlled trials (RCTs) involving 293 participants showed that IDE have a little impact on BMI with SMD of 0.0691, 95% Confidence Interval [-0.1602; 0.2984], and a p-value of 0.59 and HD duration with SMD of -0.1673, 95% Confidence Interval [-0.3968; 0.0622] and a p-value of 0.1532. Meanwhile, for KT/V, IDE show a statistically significant positive effect on KT/V with SMD of 0.6458, 95% confidence interval [- 0.0264; 1.3179] with P Value 0.05, suggesting improved HD outcomes.

Conclusion:

Intradialytic exercise appears to improve KT/V; however, its effects on other clinical outcomes, including BMI and HD, remain inconclusive. These findings are limited by heterogeneity and small sample sizes, highlighting the need for larger, high-quality randomized controlled trials