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Abstract: PO1180

Exercise Training to Improve Patient-Important Outcomes in Adults Undergoing Maintenance Dialysis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Bernier-Jean, Amelie, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  • Beruni, Nadim A., Western Sydney Local Health District, Westmead, New South Wales, Australia
  • Bondonno, Nicola P., School of Biomedical Sciences, The University of Western Australia, Royal Perth Hospital, Perth, Western Australia, Australia
  • Williams, Gabrielle J., Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
  • Teixeira-Pinto, Armando, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  • Craig, Jonathan C., College of Medicine and Public Health, Flinders University, Adelaide, New South Wales, Australia
  • Wong, Germaine, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia

Multiple trials have assessed the potential for exercise training to improve outcomes in adults undergoing dialysis. However, uncertainties exist in its relevance and sustainable benefits for patient-important outcomes.


We conducted a systematic search of the Cochrane Kidney and Transplant Specialised Register for randomised controlled trials of structured exercise programs of eight weeks or more in adults undergoing maintenance dialysis (hemodialysis or peritoneal dialysis) compared to no exercise or sham exercise. Two authors independently assessed the trials for eligibility, extracted the data and assessed the risk of bias. We conducted random-effects meta-analyses.


We identified 93 studies involving 4634 participants and 71 studies involving 3973 participants contributed to the meta-analyses. The interventions lasted from 8 weeks to 2 years and most often took place thrice weekly during hemodialysis treatments. Overall, the quality of the included studies was low.
In adults undergoing dialysis, compared with no or sham exercise, exercise training may improve fatigue, the physical component of health-related quality of life (HR-QoL)(MD 4.5, 95% CI 2.2 to 6.8 points/100: low certainty evidence), depressive symptoms (SMD 0.73, 95% CI 0.39 to 1.07: moderate certainty evidence), pain (MD 6.1 95% CI 0.5 to 11.7 points on a 100-points scale: low certainty evidence), functional capacity measured in terms of the 6 Minutes-Walk Test (MD 49.9 meters, 95% CI 37.2 to 62.6; moderate certainty evidence) and the Sit-To-Stand test (MD 2.4 cycles, 95% CI 1.8 to 3.1; moderate certainty evidence). The impact on depression was greatest for those who had maintained exercise beyond 4 months (SMD 1.26, 95% CI 0.72 to 1.80).
We could not draw conclusions for all-cause mortality, cardiovascular events, the mental component of HR-QoL, blood pressure and the safety of exercise training for adults undergoing maintenance dialysis due to the very low quality of the evidence.


In adults undergoing maintenance dialysis, exercise training is likely to improve depressive symptoms and functional capacity and may improve fatigue, the physical component of quality of life and pain.


  • Government Support - Non-U.S.