Exercise Training and Outcomes in Hemodialysis Patients: Systematic Review and Meta-Analysis

Am J Nephrol. 2019;50(4):240-254. doi: 10.1159/000502447. Epub 2019 Aug 27.


Background: Inadequate dialysis, renal hypertension, and impaired exercise capacity are factors that affect the quality of life (QoL) and mortality of adults with end-stage renal disease (ESRD) undergoing hemodialysis (HD). This systematic review provided valid evidence about the effect of exercise training on single-pool Kt/V (sp Kt/V), blood pressure, and peak uptake oxygen (VO2 peak).

Method: A systematic review and meta-analysis of published randomized controlled trials (RCTs) that evaluated the effects of no <8 weeks' exercise training on the physical fitness outcomes for adults with ESRD undergoing HD were accepted in this study.

Results: Included 20 trials (677 participants) indicated that various exercise types improved aerobic capacity, walking capacity, and health-related QoL totally. Of note, aerobic exercise and combined exercise were the predominant exercise types.

Conclusion: Based on our evidence, aerobic exercise or combined exercise at least for 8 weeks to 12 months, 3 times weekly, will be beneficial to physical conditions of the patients with ESRD undergoing HD. The clinical staff can treat patients with the evidence above. Future studies need to provide more information basis for the construction of patient exercise system by adding various exercise combinations.

Keywords: Dialysis efficacy; End-stage renal disease; Exercising training; Meta-analysis; Physical function.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Blood Pressure
  • Exercise Therapy / methods*
  • Exercise Tolerance
  • Humans
  • Kidney Failure, Chronic / rehabilitation
  • Kidney Failure, Chronic / therapy*
  • Oxygen Consumption
  • Physical Fitness
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Renal Dialysis*
  • Resistance Training
  • Treatment Outcome