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Abstract: FR-PO1101

Efficacy of Combined Exercise and Nutritional Intervention for Nondialysis-Dependent CKD: A Systematic Review

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Tsuchida, Yohei, Department of Nephrology, Shinrakuen Hospital, Niigata, Japan
  • Kabasawa, Hideyuki, Department of Clinical Nutrition Science, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
  • Uno, Chiharu, School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin, Japan
  • Nishioka, Shinta, Graduate School of School of Regional Design and Creation, University of Nagasaki, Nagasaki, Japan
  • Sofue, Tadashi, Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, Kagawa, Japan
  • Fujii, Naohiko, Department of Nephrology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan
  • Saitoh, Masakazu, Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
  • Narita, Ichiei, Niigata Institute for Health and Sports Medicine, Niigata Sports Association, Niigata, Japan
  • Yamagata, Kunihiro, Department of Nephrology, Faculty of Medicine, University of Tsukuba and Division of Preventive and Sports Nephrology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
  • Hoshino, Junichi, Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan
  • Doi, Etsuko, Department of Nutrition, Toranomon Hospital, Tokyo, Japan
  • Hosojima, Michihiro, Department of Clinical Nutrition Science, Kidney Research Center, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
Background

Various exercise and nutritional interventions have been shown to have beneficial effects in non-dialysis chronic kidney disease (CKD) patients, but their combined efficacy is unclear. This study analyzed the efficacy of combined exercise and nutritional intervention for non-dialysis CKD patients in terms of survival rate, renal function, initiation rate of renal replacement therapy (RRT), muscle mass, physical function including peak volume of oxygen uptake (VO2 peak), and quality of life (QOL).

Methods

Database searches were performed of PubMed for English-language articles and Ichu-shi web for Japanese-language articles up to 30 September 2024. Inclusion criteria were randomized controlled trials (RCTs) of adult patients with CKD (stages 3–5), excluding patients undergoing RRT and post-kidney transplant, in which the intervention group received combined exercise and nutritional intervention, and the control group received exercise intervention alone, nutritional intervention alone, or no intervention. Cochrane risk-of-bias tool for randomized trials ver. 2 and Cochrane Review Manager were used to assess the risk of bias in RCTs and meta-analyses, respectively.

Results

Five RCTs involving a total of 339 participants were analyzed. The intervention was associated with a significant improvement in VO2 peak [mean difference = 2.70; 95% confidence interval: 1.22, 4.18], but no difference in renal function was observed in non-dialysis CKD patients compared with the control. The analyzed studies had substantial heterogeneity and risk of bias. The outcomes, including survival rate, initiation rate of RRT, muscle mass, and QOL, were qualitatively summarized due to the small number of studies.

Conclusion

Combined exercise and nutritional intervention have significant benefits in terms of improving VO2 peak in non-dialysis CKD patients. More RCTs are needed in order to provide evidence-based validation of the efficacy of combined exercise and nutritional intervention for patients with non-dialysis CKD.

Funding

  • Private Foundation Support

Digital Object Identifier (DOI)