Cardiopulmonary reserve examined with cardiopulmonary exercise testing in individuals with chronic kidney disease: A systematic review and meta-analysis - 25/08/22
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Background |
Patients with chronic kidney disease (CKD) often present reduced physical activity and exercise tolerance due to factors relevant to co-existing disturbances of the cardiac, nervous and muscular systems. Cardiopulmonary exercise testing (CPET) is used for clinical evaluation of exercise limitation and related symptoms (i.e., dyspnea, fatigue) in several medical fields.
Objectives |
This is a systematic review and meta-analysis of studies using CPET technology to examine cardiopulmonary reserve in individuals with versus without CKD.
Methods |
Literature search involved PubMed, Web of Science and Scopus databases; manual search of article references and of gray literature was also performed. Observational studies and randomized trials that used CPET for patients with CKD stage 1–5 versus controls were eligible. The primary outcome was peak oxygen uptake (VO2peak). The Newcastle-Ottawa Scale was used to evaluate the quality of retrieved studies.
Results |
From an initial 4944 literature records, we identified 29 studies fulfilling the inclusion criteria; of these, 25 studies (2,213 participants) with complete data were included in the final meta-analysis. VO2peak was significantly lower in CKD patients than controls without CKD [standardized mean difference (SMD) -1.40, 95% confidence interval (CI) -1.68; -1.13)]. Values were lower for CKD than non-CKD individuals for oxygen consumption at anaerobic threshold (SMD -1.06, 95% CI -1.34; -0.79) and maximum workload [weighted mean difference (WMD) -58.26, 95% CI 74.14; -42.38]. In 3 studies, CKD patients had higher VO2peak than controls with heart failure without CKD (WMD 6.60, 95% CI 3.02; 10.18). Sensitivity analyses confirmed the robustness of these findings.
Conclusions |
VO2peak and other commonly analyzed CPET variables were lower in patients with CKD than controls, which indicates reduced functional cardiopulmonary reserve in CKD. In contrast, patients with CKD performed better than controls with heart failure without CKD. Overall, rehabilitation programs should be more widely applied to individuals with CKD.
PROSPERO registration number |
: CRD42021227805
Le texte complet de cet article est disponible en PDF.Keywords : Chronic kidney disease, Cardiopulmonary exercise testing, CPET, Exercise intolerance, Cardiovascular reserve, VO2peak
Plan
Vol 65 - N° 5
Article 101588- septembre 2022 Retour au numéro
Article précédent
- Effect of high-intensity interval training protocols on VO2max and HbA1c level in people with type 2 diabetes: A systematic review and meta-analysis
- Mariana Brondani de Mello, Natiele Camponogara Righi, Felipe Barreto Schuch, Luis Ulisses Signori, Antônio Marcos Vargas da Silva
- Quadriceps weakness associated with mortality in individuals with chronic obstructive pulmonary disease
- Thamyres Spositon, Joice M. Oliveira, Antenor Rodrigues, Jéssica Fonseca, Lais Santin, Felipe V.C. Machado, Nidia A. Hernandes, Alda Marques, Fabio Pitta, Karina C. Furlanetto
Bienvenue sur EM-consulte, la référence des professionnels de santé.