L’activité physique, un facteur protecteur cardiovasculaire et métabolique chez les patients porteurs d’une insuffisance rénale terminale

Isnard-Rouchon, Myriam; Coutard, Céline

doi:10.1016/j.nephro.2017.01.027

Cited by 4 publications

(5 citation statements)

References 37 publications

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“…Studies selected include 18 parallel arm RCTs, two randomized cross-over studies, seven nonrandomized studies that included an intervention and control group, and five single-group pre-post studies. 32 , 47 – 77 In total, 1817 individuals participated in these 32 studies, with sample sizes ranging from 6 to 174 participants (Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-two studies evaluated the effects of intradialytic aerobic exercise. 32 , 47 , 48 , 50 , 51 , 53 , 55 – 59 , 62 , 64 – 66 , 68 – 70 , 72 , 74 – 76 Four studies examined the effects of resistance exercise. 54 , 61 , 73 , 77 Five studies included both aerobic and resistance exercise.…”

Section: Resultsmentioning

confidence: 99%

“…One cohort study ( n =66) of intradialytic cycling for 30 minutes twice weekly for 2 years demonstrated fewer cardiovascular hospitalizations with exercise ( n =5) than in controls ( n =14) in unadjusted analysis. 72 One RCT of intradialytic cycling for 6 months showed a decline in overall number of cardiovascular hospital admissions during ( n =8) and 6 months after ( n =5) the intervention period as compared with the pretrial period ( n =9) in the exercise group, while admissions increased during ( n =3) and after ( n =7) the trial period compared with pretrial in controls ( n =1) (Table 4 ). 78 …”

Section: Resultsmentioning

confidence: 99%

“…One cohort study (n566) of intradialytic cycling for 30 minutes twice weekly for 2 years demonstrated fewer cardiovascular hospitalizations with exercise (n55) than in controls (n514) in unadjusted analysis. 72 One RCT of intradialytic cycling for 6 months showed a decline in overall number of cardiovascular hospital admissions during (n58) and 6 months after (n55) the intervention period as compared with the pretrial period (n59) in the exercise group, while admissions increased during (n53) and after (n57) the trial period compared with pretrial in controls (n51) (Table 4). 78 An RCT studying a 6-month combined intradialytic cycling and resistance program demonstrated no significant difference in number of cardiovascular deaths in the exercise group (n52; 1%) as compared with nonexercise controls (n53; 2%) (Table 4).…”

Section: Cardiovascular Hospitalization and Mortalitymentioning

confidence: 99%

“…67 Adverse Events, Adherence, and Study Attrition Only 19/32 studies reported adverse events. [47][48][49][50]52,53,58,60,61,[65][66][67][68][69][70]72,74,75,77 Across these studies, 248 adverse events occurred, with 135 (54.4%) occurring in the intervention groups and 113 (45.6%) in the control groups. Of the adverse events in the intervention group, only one was identified to be related to exercise.…”

Section: Cardiovascular Hospitalization and Mortalitymentioning

confidence: 99%

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Effect of Intradialytic Exercise on Cardiovascular Outcomes in Maintenance Hemodialysis: A Systematic Review and Meta-Analysis

Verrelli,

Sharma,

Alexiuk

et al. 2024

Kidney360

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Background: Cardiovascular disease is the leading cause of death among people with kidney failure on hemodialysis, for whom improving cardiovascular health is a research priority. Intradialytic myocardial stunning is common and associated with adverse cardiovascular events. Intradialytic exercise may mitigate intradialytic myocardial stunning and improve cardiovascular structure and function. This systematic review investigated the effect of intradialytic exercise on cardiovascular outcomes in adults undergoing maintenance hemodialysis (PROSPERO #CRD42018103118). Methods: Following PRISMA guidelines, we systematically searched MEDLINE, EMBASE, Cochrane CENTRAL, SportDiscus, and PEDro databases from 1960 until June 2022, for randomized and non-randomized studies investigating the effect of intradialytic exercise programs on objective cardiovascular outcomes, pre-specified as primary or secondary outcomes. The primary outcome was arterial resistance. Results: Of 10837 references identified, 32 met eligibility criteria. These studies investigated the effect of intradialytic exercise on arterial resistance (8 studies), blood pressure (20 studies), myocardial structure and function (7 studies), endothelial function (2 studies), sympathetic overactivity (9 studies), biomarkers of cardiac injury (3 studies), cardiovascular hospitalization and mortality (2 studies). Most studies used aerobic exercise as the intervention and usual care (no exercise) controls. Meta-analysis of intradialytic exercise versus usual care resulted in a statistically significant reduction in arterial resistance measured by pulse wave velocity (PWV) with mean difference -1.63 m/sec (95% CI -2.51, -0.75). Meta-analyses for diastolic blood pressure, left ventricular ejection fraction (LVEF), and low-frequency/high-frequency (LF/HF ratio) measure of heart rate variability also showed statistically significant improvements with exercise. There was no significant difference in change in systolic blood pressure, augmentation index, and left ventricular mass index between groups. Conclusion: Intradialytic exercise programming resulted in a clinically meaningful improvement to PWV, a component of arterial resistance. Sseveral physiologic measures of cardiovascular health, including diastolic blood pressure, LVEF and heart rate variability measured by the LF/HF ratio were also observed. The effects of intradialytic exercise on major adverse cardiovascular events remains uncertain.

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