Benefits of physical exercises in chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials

Clinical Snapshot

Key Findings

• P Value: Statistically significant results implied but specific p-values not reported

• Effect Size: Not specified in abstract

• Primary Outcome: Significant reduction in all-cause mortality, particularly in dialysis-dependent patients

• Nnt Or Sensitivity: Not calculable from available data - would require access to full manuscript

• Confidence Interval: 95% confidence intervals reported but specific values not provided

Clinical Application

High feasibility as exercise interventions are generally accessible and cost-effective, aligning with existing Australian clinical practice guidelines Highly relevant to Australian practice - supports RACGP chronic disease management plans, potentially eligible for Medicare chronic disease management items, and aligns with Kidney Health Australia exercise recommendations CKD patients across all stages, including both dialysis-dependent and non-dialysis patients in Australian nephrology practice

Abstract

Physical exercise has been proven to be beneficial for chronic kidney disease (CKD) patients; however, there is a lack of a comprehensive summary of existing literature, especially the results from randomized controlled trials (RCTs). We had conducted a systematic review and meta-analysis to evaluate the benefits of physical exercise in chronic kidney disease. Outcomes were classified into all-cause mortality, cardiovascular, pulmonary, and renal outcomes, inflammatory indices, laboratory tests, and physical indices. The risk of bias was assessed using the Cochrane criteria. Relative risk ratios with 95% confidence intervals (CIs) for categorical variables, and weighted mean difference or standardized mean differences with 95% CIs for continuous variables were pooled using a random-effects model. Publication bias was assessed using Funnel plot analysis and Egger's Test. At last, 82 studies were included, and the results of the meta-analysis show that the physical exercises can significantly reduce all-cause mortality, particularly in dialysis dependent patients. Cardiovascular function, reflected by 6-minute walk test and blood pressure and pulmonary function, reflected by peak oxygen uptake, forced expiratory volume in 1 second, and forced vital capacity, all improved after physical exercise interventions. Physical exercises helped to increase the dialysis adequacy and preserve the residual renal function. C-reactive protein and interleukin-6 levels decreased, and hemoglobin and albumin levels increased upon physical exercise interventions. The fat mass decreased after physical exercise interventions in non-dialysis patients. We concluded that physical exercise is beneficial for CKD patients, independent of the modes or locations of exercise.

References

1. 1.Chen, Y., Ren, S., Yao, X., Li, M., Li, G., Feng, Y., & Shi, X. (2026). Benefits of physical exercises in chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials. Renal Failure. https://doi.org/10.1080/0886022X.2026.2654288