The effect of exercise training on quality of life in people with chronic kidney disease requiring dialysis. A systematic review with meta-analysis

Annette Traise; Gudrun Dieberg; Elizabeth Degotardi; Bailey Hart; Fiza Kaippilly; Darcy McInnes; Melissa J Pearson; David Ryan; Neil A Smart

doi:10.1007/s40620-025-02245-1

The effect of exercise training on quality of life in people with chronic kidney disease requiring dialysis. A systematic review with meta-analysis

J Nephrol. 2025 Apr;38(3):893-911. doi: 10.1007/s40620-025-02245-1. Epub 2025 Mar 28.

Authors

Annette Traise¹, Gudrun Dieberg², Elizabeth Degotardi², Bailey Hart², Fiza Kaippilly², Darcy McInnes², Melissa J Pearson², David Ryan², Neil A Smart²

Affiliations

¹ Clinical Exercise Physiology, School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia. atraise@myune.edu.au.
² Clinical Exercise Physiology, School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia.

Abstract

Background: Chronic kidney disease (CKD) is a debilitating condition associated with poor health outcomes, including reduced quality of life (QoL), frequent hospitalisation and premature mortality.

Aim: This study aimed to determine the effect of exercise training on health-related QoL in individuals with CKD requiring dialysis, focusing on mental health scores. Secondary aims included analysing the effect of exercise modality, intensity, and delivery context to maximise exercise training benefits for QoL. Additionally, differences in mental component summary and physical component summary scores using CKD-specific generic QoL patient reported outcome measures were examined.

Methods: A systematic search of MEDLINE, EMBASE, the Cochrane Library of Controlled Trials, CINAHL, and SPORTDiscus up to November 14th, 2024, identified randomised controlled trials (RCTs) comparing exercise training to usual care in CKD patients requiring dialysis. Twenty-five RCTs met the inclusion criteria and were pooled for meta-analyses.

Results: Pooled analysis revealed significant improvements in QoL scores for mental component summary (MD 3.33 [1.24, 5.41], p = 0.002) and physical component summary (MD 3.75, [2.28, 5.23], p < 0.00001) compared to the usual care. A statistically significant improvement in the mental component summary was found for aerobic training (p = 0.02) and resistance training (p = 0.04). Moderate intensity (p = 0.003), an intervention duration of 12-26 weeks (p = 0.0004), interdialytic delivery (p = 0.003), intradialytic delivery (p = 0.03) and supervised training (p = 0.002) all demonstrated statistically significant improvements in mental component summary. The short form (SF)-36 demonstrated significant improvements in mental component summary (MD 4.15 [1.54, 6.76], p = 0.002), while the kidney disease QoL patient-reported outcome measure did not show significant improvement (p = 0.33).

Conclusions: Supervised, inter-dialytic or intra-dialytic exercise, including aerobic or resistance training at a moderate intensity for up to 26 weeks, can significantly improve mental component summary scores in individuals with stage 5 CKD on dialysis.

Keywords: Chronic kidney disease; Dialysis; Exercise; Quality of life.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Exercise Therapy* / methods
Humans
Mental Health
Quality of Life*
Randomized Controlled Trials as Topic
Renal Dialysis*
Renal Insufficiency, Chronic* / psychology
Renal Insufficiency, Chronic* / therapy
Treatment Outcome