title: Exercise training in adults with CKD: a systematic review and meta-analysis.
abstract: BACKGROUND
  Whether exercise can affect health outcomes in people with chronic kidney disease (CKD) and what the optimal exercise strategies are for patients with CKD remain uncertain.
  
  
  METHODS
  Systematic review and meta-analysis of randomized controlled trials.
  
  
  METHODS
  Adults with CKD stages 2-5, dialysis therapy, or a kidney transplant.
  
  
  METHODS
  Trials evaluating regular exercise training outcomes identified by searches in Cochrane CENTRAL, MEDLINE, EMBASE, CINAHL, Web of Science, BIOSIS, PEDro, AMED, AgeLine, PsycINFO, and KoreaMed, without language restriction.
  
  
  METHODS
  Regular exercise training for at least 8 weeks.
  
  
  RESULTS
  Vary by study but could include aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and health-related quality of life. Treatment effects were summarized as standardized difference with 95% CIs using random-effects meta-analysis.
  
  
  RESULTS
  41 trials (928 participants) comparing exercise training with sham exercise or no exercise were included; overall, improved aerobic capacity, muscular functioning, cardiovascular function, walking capacity, and health-related quality of life were associated with various exercise interventions, although the preponderance of data were for dialysis patients and used aerobic exercise programs.
  
  
  CONCLUSIONS
  Unclear or high risk of bias in 32% of the trials, few trial data concerning resistance training, and limited data for several important outcomes.
  
  
  CONCLUSIONS
  Regular exercise training generally is associated with improved health outcomes in individuals with CKD. Correctly designed exercise rehabilitation may be an effective part of care for adults with CKD. Future studies should examine longer term outcomes and strategies to translate exercise done in a supervised setting to the home setting for broader applicability.
authors.affiliation: Department of Clinical Science, Karolinska Institutet, Stockholm, Sweden; Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Division of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden. Electronic address: susanne.heiwe@ki.se.
authors.forename: Susanne
authors.initials: S
authors.lastname: Heiwe
authors.affiliation: Division of Nephrology, Danderyd University Hospital, Stockholm, Sweden; Division of Nephrology, Danderyd University Hospital, Stockholm, Sweden.
authors.forename: Stefan H
authors.initials: SH
authors.lastname: Jacobson
mesh_terms: D005081:Exercise Therapy; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000534:rehabilitation*
keywords: Kidney disease, chronic; exercise; exercise training; meta-analysis; physical fitness; systematic reviews