Effects of exercise on markers of inflammation and indicators of nutrition in patients with chronic kidney disease: a systematic review and meta-analysis

This meta-analysis aimed to reveal the effects of exercise training on markers of inflammation and indicators of nutrition in non-dialysis-dependent patients with chronic kidney disease (NDD-CKD). We searched the MEDLINE, EMBASE, CENTRAL, Web of Science, CINAHL, CNKI, WANFANE, VIP, and CBM databases, from their inception up to October 2020 to identify randomized controlled trials that examined the effects of exercise training on inflammation and nutrition in NDD-CKD patients. A total of 16 trials, comprising 724 patients, were included in the analysis. The BMI (P = 0.005) and waist circumference (P = 0.004) decreased significantly after exercise training in NDD-CKD patients. Similarly, IL-6 (P = 0.03) decreased after exercise training in NDD-CKD patients. However, serum albumin level, body fat, CRP and hs-CRP were not different between patients who received exercise training and those who received usual care. Furthermore, BMI (P = 0.009), body weight (P = 0.009), and waist circumference (P = 0.010) were decreased in overweight patients (BMI ≧ 25 kg/m2). Moreover, BMI (P = 0.003), body weight (P = 0.005), and waist circumference (P = 0.007) reduced when the length of intervention exceeded 48 weeks. Subgroup analyses revealed no significant alteration of serum albumin, body fat, CRP, or hs-CRP, when studies were divided based on BMI or intervention duration. Overall, these findings suggest that exercise training may improve inflammation status in NDD-CKD patients, and enhance weight loss in obese adult CKD patients. Registration number: INPLASY2020100025.