Skip to main content
Erschienen in: Sports Medicine 8/2014

01.08.2014 | Systematic Review

Effect of Progressive Resistance Training on Measures of Skeletal Muscle Hypertrophy, Muscular Strength and Health-Related Quality of Life in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis

verfasst von: Birinder S. Cheema, Danwin Chan, Paul Fahey, Evan Atlantis

Erschienen in: Sports Medicine | Ausgabe 8/2014

Einloggen, um Zugang zu erhalten

Abstract

Background and Objective

Skeletal muscle wasting resulting in reduced muscular strength and health-related quality of life (HR-QOL) is common in chronic kidney disease (CKD) and may be reversed with progressive resistance training (PRT). Therefore, we systematically assessed the effect of PRT on measures of skeletal muscle hypertrophy, muscular strength and HR-QOL in this cohort to inform clinical practice and guidelines.

Design

We performed a systematic review and meta-analysis.

Inclusion Criteria

We included randomised controlled trials (RCTs) that investigated the independent effect of PRT (>6 weeks) on measures of skeletal muscle hypertrophy [muscle mass or cross-sectional area (CSA)], muscular strength and/or HR-QOL in adults with CKD.

Data Extraction and Analysis

The standardised mean difference (SMD) from each study was pooled to produce an overall estimate of effect and associated 95 % confidence interval (95 % CI) between treatment and control groups on primary outcomes.

Results

Seven RCTs in 271 patients with Stage 3–5 CKD yielded seven studies on muscular strength (N = 249), six studies on total body muscle mass (N = 200) and six studies on HR-QOL (N = 223). PRT significantly improved standardised muscular strength [SMD 1.15 (95 % CI 0.80–1.49)] and HR-QOL [SMD 0.83 (95 % CI 0.51–1.16)], but not total body muscle mass [SMD 0.29 (95 % CI −0.27 to 0.86)] in our primary analysis. However, secondary analysis of six studies showed that PRT induced significant muscle hypertrophy of the lower extremities (leg mass, or mid-thigh or quadriceps CSA) [SMD 0.43 (95 % CI 0.11–0.76)], a pertinent analysis given that most studies implemented lower-body PRT only.

Conclusions

Robust evidence from RCTs indicates that PRT can induce skeletal muscle hypertrophy and increase muscular strength and HR-QOL outcomes in men and women with CKD. Therefore, clinical practice guidelines should be updated to inform clinicians on the benefits of PRT in this cohort.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat USRDS: U.S. Renal Data System, USRDS 2009 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2011. USRDS: U.S. Renal Data System, USRDS 2009 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2011.
2.
Zurück zum Zitat Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260–72.PubMedCrossRef Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260–72.PubMedCrossRef
3.
Zurück zum Zitat El Nahas AM, Bello AK. Chronic kidney disease: the global challenge. Lancet. 2005;365(9456):331–40.CrossRef El Nahas AM, Bello AK. Chronic kidney disease: the global challenge. Lancet. 2005;365(9456):331–40.CrossRef
4.
Zurück zum Zitat Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73(4):391–8.PubMedCrossRef Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73(4):391–8.PubMedCrossRef
5.
Zurück zum Zitat Kopple J. Pathophysiology of protein-energy wasting in chronic renal failure. J Nutr. 1999;129(1S Suppl):247S–51S.PubMed Kopple J. Pathophysiology of protein-energy wasting in chronic renal failure. J Nutr. 1999;129(1S Suppl):247S–51S.PubMed
6.
Zurück zum Zitat Workeneh BT, Mitch WE. Review of muscle wasting associated with chronic kidney disease. Am J Clin Nutr. 2010;91(4):1128S–32S.PubMedCrossRef Workeneh BT, Mitch WE. Review of muscle wasting associated with chronic kidney disease. Am J Clin Nutr. 2010;91(4):1128S–32S.PubMedCrossRef
7.
Zurück zum Zitat Johansen KL, Chertow GM, Ng AV, et al. Physical activity levels in patients on hemodialysis and healthy sedentary controls. Kidney Int. 2000;57:2564–70.PubMedCrossRef Johansen KL, Chertow GM, Ng AV, et al. Physical activity levels in patients on hemodialysis and healthy sedentary controls. Kidney Int. 2000;57:2564–70.PubMedCrossRef
8.
Zurück zum Zitat Caso G, Garlick P. Control of muscle protein kinetics by acid-base balance. Curr Opin Clin Nutr Metab Care. 2005;8(1):73–6.PubMedCrossRef Caso G, Garlick P. Control of muscle protein kinetics by acid-base balance. Curr Opin Clin Nutr Metab Care. 2005;8(1):73–6.PubMedCrossRef
9.
Zurück zum Zitat Raj D, Zager P, Shah V, et al. Protein turnover and amino acid transport kinetics in end-stage renal disease. Am J Physiol Endocrinol Metab. 2004;286:E136–43.PubMedCrossRef Raj D, Zager P, Shah V, et al. Protein turnover and amino acid transport kinetics in end-stage renal disease. Am J Physiol Endocrinol Metab. 2004;286:E136–43.PubMedCrossRef
10.
Zurück zum Zitat John SG, Sigrist MK, Taal MW, et al. Natural history of skeletal muscle mass changes in chronic kidney disease stage 4 and 5 patients: an observational study. PLoS One. 2013;8(5):e65372.PubMedCrossRefPubMedCentral John SG, Sigrist MK, Taal MW, et al. Natural history of skeletal muscle mass changes in chronic kidney disease stage 4 and 5 patients: an observational study. PLoS One. 2013;8(5):e65372.PubMedCrossRefPubMedCentral
11.
Zurück zum Zitat Cheema B, Abas H, Smith B, et al. Investigation of skeletal muscle quantity and quality in end-stage renal disease. Nephrology (Carlton). 2010;15:454–63.CrossRef Cheema B, Abas H, Smith B, et al. Investigation of skeletal muscle quantity and quality in end-stage renal disease. Nephrology (Carlton). 2010;15:454–63.CrossRef
12.
Zurück zum Zitat Johansen KL, Shubert T, Doyle J, et al. Muscular atrophy in patients receiving hemodialysis: effects on muscle strength, muscle quality, and physical function. Kidney Int. 2003;63:291–7.PubMedCrossRef Johansen KL, Shubert T, Doyle J, et al. Muscular atrophy in patients receiving hemodialysis: effects on muscle strength, muscle quality, and physical function. Kidney Int. 2003;63:291–7.PubMedCrossRef
13.
Zurück zum Zitat McClellan WM, Anson C, Birkeli K, et al. Functional status and quality of life: predictors of early mortality among patients entering treatment for end stage renal disease. J Clin Epidemiol. 1991;44(1):83–9.PubMedCrossRef McClellan WM, Anson C, Birkeli K, et al. Functional status and quality of life: predictors of early mortality among patients entering treatment for end stage renal disease. J Clin Epidemiol. 1991;44(1):83–9.PubMedCrossRef
14.
Zurück zum Zitat Desmeules S, Levesque R, Jaussent I, et al. Creatine index and lean body mass are excellent predictors of long-term survival in haemodiafiltration patients. Nephrol Dial Transplant. 2004;19(5):1182–9.PubMedCrossRef Desmeules S, Levesque R, Jaussent I, et al. Creatine index and lean body mass are excellent predictors of long-term survival in haemodiafiltration patients. Nephrol Dial Transplant. 2004;19(5):1182–9.PubMedCrossRef
15.
Zurück zum Zitat Roshanravan B, Robinson-Cohen C, Patel KV, et al. Association between physical performance and all-cause mortality in CKD. J Am Soc Nephrol. 2013;24(5):822–30.PubMedCrossRefPubMedCentral Roshanravan B, Robinson-Cohen C, Patel KV, et al. Association between physical performance and all-cause mortality in CKD. J Am Soc Nephrol. 2013;24(5):822–30.PubMedCrossRefPubMedCentral
16.
Zurück zum Zitat Knight EL, Ofsthun N, Teng M, et al. The association between mental health, physical function, and hemodialysis mortality. Kidney Int. 2003;63(5):1843–51.PubMedCrossRef Knight EL, Ofsthun N, Teng M, et al. The association between mental health, physical function, and hemodialysis mortality. Kidney Int. 2003;63(5):1843–51.PubMedCrossRef
17.
Zurück zum Zitat DeOreo P. Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance. Am J Kidney Dis. 1997;30(2):204–12.PubMedCrossRef DeOreo P. Hemodialysis patient-assessed functional health status predicts continued survival, hospitalization, and dialysis-attendance compliance. Am J Kidney Dis. 1997;30(2):204–12.PubMedCrossRef
18.
Zurück zum Zitat Lowrie EG, Curtin RB, LePain N, et al. Medical outcomes study short form-36: a consistent and powerful predictor of morbidity and mortality in dialysis patients. Am J Kidney Dis. 2003;41(6):1286–92.PubMedCrossRef Lowrie EG, Curtin RB, LePain N, et al. Medical outcomes study short form-36: a consistent and powerful predictor of morbidity and mortality in dialysis patients. Am J Kidney Dis. 2003;41(6):1286–92.PubMedCrossRef
19.
Zurück zum Zitat Fiatarone Singh M. Exercise comes of age: rationale and recommendations for a geriatric exercise prescription. J Gerontol A Biol Sci Med Sci. 2002;57A:M262–82.CrossRef Fiatarone Singh M. Exercise comes of age: rationale and recommendations for a geriatric exercise prescription. J Gerontol A Biol Sci Med Sci. 2002;57A:M262–82.CrossRef
20.
Zurück zum Zitat Cheema B, Fiatarone Singh M. Exercise training in patients receiving maintenance hemodialysis: a systematic review of clinical trials. Am J Nephrol. 2005;25:352–64.PubMedCrossRef Cheema B, Fiatarone Singh M. Exercise training in patients receiving maintenance hemodialysis: a systematic review of clinical trials. Am J Nephrol. 2005;25:352–64.PubMedCrossRef
21.
Zurück zum Zitat Cheema B, Smith B, Fiatarone Singh M. A rationale for intradialytic exercise training as standard clinical practice in end stage renal disease. Am J Kidney Dis. 2005;45:912–6.PubMedCrossRef Cheema B, Smith B, Fiatarone Singh M. A rationale for intradialytic exercise training as standard clinical practice in end stage renal disease. Am J Kidney Dis. 2005;45:912–6.PubMedCrossRef
22.
Zurück zum Zitat Chan M, Cheema B, Fiatarone Singh M. Progressive resistance training and nutrition in renal failure. J Ren Nutr. 2007;17(1):84–7.PubMedCrossRef Chan M, Cheema B, Fiatarone Singh M. Progressive resistance training and nutrition in renal failure. J Ren Nutr. 2007;17(1):84–7.PubMedCrossRef
23.
Zurück zum Zitat Cheema B, Chan D. Resistance training in chronic kidney disease. In: Ciccolo J, Kraemer W, editors. Resistance training for the prevention and treatment of chronic disease. Boca Raton: Taylor & Francis; 2014. Cheema B, Chan D. Resistance training in chronic kidney disease. In: Ciccolo J, Kraemer W, editors. Resistance training for the prevention and treatment of chronic disease. Boca Raton: Taylor & Francis; 2014.
24.
Zurück zum Zitat Smart N, Steele M. Exercise training in haemodialysis patients: a systematic review and meta-analysis. Nephrology (Carlton). 2011;16:626–32. Smart N, Steele M. Exercise training in haemodialysis patients: a systematic review and meta-analysis. Nephrology (Carlton). 2011;16:626–32.
25.
Zurück zum Zitat Smart NA, Williams AD, Levinger I, et al. Exercise and Sports Science Australia (ESSA) position statement on exercise and chronic kidney disease. J Sci Med Sport. 2013;21(13):005. Smart NA, Williams AD, Levinger I, et al. Exercise and Sports Science Australia (ESSA) position statement on exercise and chronic kidney disease. J Sci Med Sport. 2013;21(13):005.
26.
Zurück zum Zitat Johansen K, Painter P, Sakkas G, et al. Effects of resistance exercise training and nandrolone decanoate on body composition and muscle function among patients who receive hemodialysis: a randomized controlled trial. J Am Soc Nephrol. 2006;17:2307–14.PubMedCrossRef Johansen K, Painter P, Sakkas G, et al. Effects of resistance exercise training and nandrolone decanoate on body composition and muscle function among patients who receive hemodialysis: a randomized controlled trial. J Am Soc Nephrol. 2006;17:2307–14.PubMedCrossRef
27.
Zurück zum Zitat Cheema B, Abas H, Smith B, et al. Progressive exercise for anabolism in kidney disease (PEAK): a randomized controlled trial of resistance training during hemodialysis. J Am Soc Nephrol. 2007;18(5):1594–601.PubMedCrossRef Cheema B, Abas H, Smith B, et al. Progressive exercise for anabolism in kidney disease (PEAK): a randomized controlled trial of resistance training during hemodialysis. J Am Soc Nephrol. 2007;18(5):1594–601.PubMedCrossRef
28.
Zurück zum Zitat Chen JL, Godfrey S, Ng TT, et al. Effect of intra-dialytic, low-intensity strength training on functional capacity in adult haemodialysis patients: a randomized pilot trial. Nephrol Dial Transplant. 2010;25(6):1936–43.PubMedCrossRefPubMedCentral Chen JL, Godfrey S, Ng TT, et al. Effect of intra-dialytic, low-intensity strength training on functional capacity in adult haemodialysis patients: a randomized pilot trial. Nephrol Dial Transplant. 2010;25(6):1936–43.PubMedCrossRefPubMedCentral
29.
Zurück zum Zitat de Lima MC, Cicotoste Cde L, Cardoso KDa S, et al. Effect of exercise performed during hemodialysis: strength versus aerobic. Ren Fail. 2013;35(5):697–704.PubMedCrossRef de Lima MC, Cicotoste Cde L, Cardoso KDa S, et al. Effect of exercise performed during hemodialysis: strength versus aerobic. Ren Fail. 2013;35(5):697–704.PubMedCrossRef
30.
Zurück zum Zitat Castaneda C, Gordon P, Uhlin K, et al. Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency. A randomized, controlled trial. Ann Intern Med. 2001;135:965–76.PubMedCrossRef Castaneda C, Gordon P, Uhlin K, et al. Resistance training to counteract the catabolism of a low-protein diet in patients with chronic renal insufficiency. A randomized, controlled trial. Ann Intern Med. 2001;135:965–76.PubMedCrossRef
31.
Zurück zum Zitat Dong J, Sundell MB, Pupim LB, et al. The effect of resistance exercise to augment long-term benefits of intradialytic oral nutritional supplementation in chronic hemodialysis patients. J Ren Nutr. 2011;21(2):149–59.PubMedCrossRefPubMedCentral Dong J, Sundell MB, Pupim LB, et al. The effect of resistance exercise to augment long-term benefits of intradialytic oral nutritional supplementation in chronic hemodialysis patients. J Ren Nutr. 2011;21(2):149–59.PubMedCrossRefPubMedCentral
32.
Zurück zum Zitat Song WJ, Sohng KY. Effects of progressive resistance training on body composition, physical fitness and quality of life of patients on hemodialysis. J Korean Acad Nurs. 2012;42(7):947–56.PubMedCrossRef Song WJ, Sohng KY. Effects of progressive resistance training on body composition, physical fitness and quality of life of patients on hemodialysis. J Korean Acad Nurs. 2012;42(7):947–56.PubMedCrossRef
33.
Zurück zum Zitat Cheema B. Tackling the survival issue in end stage renal disease: Time to get physical on haemodialysis. Nephrology (Carlton). 2008;3(7):560–9.CrossRef Cheema B. Tackling the survival issue in end stage renal disease: Time to get physical on haemodialysis. Nephrology (Carlton). 2008;3(7):560–9.CrossRef
34.
Zurück zum Zitat KDOQI clinical practice guideline for diabetes and CKD. 2012 update. Am J Kidney Dis. 2012;60(5):850–86.CrossRef KDOQI clinical practice guideline for diabetes and CKD. 2012 update. Am J Kidney Dis. 2012;60(5):850–86.CrossRef
35.
36.
Zurück zum Zitat DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.PubMedCrossRef DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.PubMedCrossRef
39.
Zurück zum Zitat Higgins J, Thompson S. Quantifying heterogeneity in meta-analysis. Stat Med. 2002;21(11):1539–58.PubMedCrossRef Higgins J, Thompson S. Quantifying heterogeneity in meta-analysis. Stat Med. 2002;21(11):1539–58.PubMedCrossRef
40.
Zurück zum Zitat Eggers M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–63.CrossRef Eggers M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–63.CrossRef
41.
Zurück zum Zitat Cheema B, Lassere M, Shnier R, et al. Rotator cuff tear in an elderly woman performing progressive resistance training: case report from a randomized controlled trial. J Phys Act Health. 2007;4(1):1–8. Cheema B, Lassere M, Shnier R, et al. Rotator cuff tear in an elderly woman performing progressive resistance training: case report from a randomized controlled trial. J Phys Act Health. 2007;4(1):1–8.
42.
Zurück zum Zitat Honda H, Qureshi A, Axelsson J, et al. Obese sarcopenia in patients with end-stage renal disease is associated with inflammation and increased mortality. Am J Clin Nutr. 2007;86(3):633–8.PubMed Honda H, Qureshi A, Axelsson J, et al. Obese sarcopenia in patients with end-stage renal disease is associated with inflammation and increased mortality. Am J Clin Nutr. 2007;86(3):633–8.PubMed
43.
Zurück zum Zitat Carrero JJ, Chmielewski M, Axelsson J, et al. Muscle atrophy, inflammation and clinical outcome in incident and prevalent dialysis patients. Clin Nutr. 2008;27(4):557–64.PubMedCrossRef Carrero JJ, Chmielewski M, Axelsson J, et al. Muscle atrophy, inflammation and clinical outcome in incident and prevalent dialysis patients. Clin Nutr. 2008;27(4):557–64.PubMedCrossRef
44.
Zurück zum Zitat Chang YT, Wu HL, Guo HR, et al. Handgrip strength is an independent predictor of renal outcomes in patients with chronic kidney diseases. Nephrol Dial Transplant. 2011;26(11):3588–95.PubMedCrossRef Chang YT, Wu HL, Guo HR, et al. Handgrip strength is an independent predictor of renal outcomes in patients with chronic kidney diseases. Nephrol Dial Transplant. 2011;26(11):3588–95.PubMedCrossRef
45.
Zurück zum Zitat Kalantar-Zadeh K, Kopple JD, Block G, et al. Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. J Am Soc Nephrol. 2001;12(12):2797–806.PubMed Kalantar-Zadeh K, Kopple JD, Block G, et al. Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis. J Am Soc Nephrol. 2001;12(12):2797–806.PubMed
Metadaten
Titel
Effect of Progressive Resistance Training on Measures of Skeletal Muscle Hypertrophy, Muscular Strength and Health-Related Quality of Life in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis
verfasst von
Birinder S. Cheema
Danwin Chan
Paul Fahey
Evan Atlantis
Publikationsdatum
01.08.2014
Verlag
Springer International Publishing
Erschienen in
Sports Medicine / Ausgabe 8/2014
Print ISSN: 0112-1642
Elektronische ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-014-0176-8

Weitere Artikel der Ausgabe 8/2014

Sports Medicine 8/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.