Mr Thai Binh Tran, Ms Noor Ul Eman Tahir, Mr Alexander Bates, Ms Jennifer Nguyễn, Doctor Hicham Ibrahim Cheikh Hassan, A/Prof Jeanette Thom, Dr Shaundeep Sen, Assoc Prof Kelly Lambert, Ria Arnold
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引用次数: 0
摘要
体育锻炼对慢性肾脏病(CKD)患者保持健康非常重要。然而,慢性肾脏病患者的健康状况往往比较复杂,因此需要针对他们的安全状况提出建议。因此,本研究旨在回顾有关 CKD 患者体育锻炼的临床实践建议,并评估研究参与者与真实世界队列相比的代表性。为了确定针对 CKD 3-5 期患者的体育锻炼建议,我们进行了系统性检索。确定了为这些建议提供依据的主要研究并提取了数据。根据性别、年龄和合并症对比例进行了元分析,并与伊拉瓦拉-肖尔海文健康研究中心人口数据库中的 679 名 CKD 患者进行了比较。针对慢性肾脏病患者的体育锻炼建议有 17 项。其中 13 项为普通成年人提供了体育锻炼指南。三项建议为运动处方提供了具体指导。这些建议参考了 34 项主要研究,包括 22 项干预研究(65%)、6 项病因研究(18%)、4 项预后研究(12%)和 2 项筛查研究(6%)。12 项干预研究为随机对照试验(55%)。主要干预研究包括 1,792 名参与者。与真实世界队列相比,研究参与者明显更年轻(平均年龄为 59.7 岁 vs 78.2 岁);男性(60% vs 51%)、高血压(89% vs 80%)和外周血管疾病(12% vs 6%)的比例更高;但冠状动脉疾病(16% vs 20%)和糖尿病(35% vs 38%)的比例较低。针对慢性肾脏病患者的体育锻炼建议缺乏针对慢性肾脏病患者复杂的健康状况和安全状况的具体、有针对性的建议。为这些建议提供依据的初级干预研究中的参与者更年轻,与现实世界中的队列相比,他们的合并症情况也有所不同。未来需要进行具有实用性设计的干预试验,以提高建议的证据基础和针对性。
PHYSICAL ACTIVITY RECOMMENDATIONS FOR PEOPLE WITH CHRONIC KIDNEY DISEASE: ARE RESEARCH PARTICIPANTS REPRESENTATIVE OF REAL-WORLD PATIENTS?
Physical activity is important to maintain good health for people with chronic kidney disease (CKD). However, people with CKD often have a complex health status which necessitates advice tailored to their safety profile. As such, this study aimed to review clinical practice recommendations on physical activity for people with CKD and evaluate how representative research participants are compared to a real-world cohort.
A systematic search was completed to identify physical activity recommendations for people with CKD Stage 3-5. Primary studies that informed these recommendations were identified and data extracted. Meta-analysis of proportion was undertaken for sex, age, and comorbidities and compared to n=679 people with CKD from the Centre for Health Research Illawarra-Shoalhaven Population database.
There were 17 physical activity recommendations for people with CKD. Thirteen provided physical activity guidelines for general adult populations. Three provided specific guidance on exercise prescription. Thirty-four primary studies informed these recommendations, including 22 intervention (65%); 6 aetiology (18%); 4 prognosis (12%); and 2 screening studies (6%). Twelve interventional studies were randomised controlled trials (55%). Primary intervention studies comprised 1,792 participants. Compared to the real-world cohort, research participants were significantly younger (mean age 59.7 vs 78.2); had higher proportions of male (60% vs 51%), hypertension (89% vs 80%) and peripheral vascular disease (12% vs 6%); but lower proportions of coronary artery disease (16% vs 20%) and diabetes (35% vs 38%).
Physical activity recommendations for people with CKD lacked specific, tailored advice to address the complex health status and safety profile of people with CKD. Primary intervention studies that inform these recommendations included participants that were younger and had different comorbid profile when compared to a real-world cohort. Future intervention trials with pragmatic design are needed to improve the evidence base and specificity of recommendations.