The effectiveness of aerobic exercise in improving blood results of haemodialysis patients

Abstract

Patients suffering from Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD) commonly suffer from symptoms associated with the 'uraemic syndrome'. These symptoms are worsened by the fact that the majority of these patients live a sedentary lifestyle. Exercise is an intervention which can help reduce these symptoms and improve these patients' health-related quality of life, however, exercise is still under-utilised. The aim of this dissertation is to investigate the effects of aerobic exercise on the blood results of the haemodialysis population. The research question which was formulated using the PICO framework was; 'Is aerobic exercise effective in improving blood results of haemodialysis patients?' The population chosen was that of haemodialysis patients over the age of 18, the intervention was aerobic exercise, the comparison was no exercise, and the outcome was blood results. The inclusion criteria incorporate studies published between 1999 and 2012 and those in English. Studies focusing on types of exercise other than aerobic, a combination of exercises, those focusing on patients undergoing peritoneal dialysis (PD) and outcomes other than blood results were excluded. The literature search employed 8 databases and produced 12 key studies which met the inclusion and exclusion criteria. The tools used for analysis of the studies included an algorithm published by the NICE guidelines (2005), the CASP tool for systematic reviews and the McMaster tool. Following their appraisal, the main conclusion drawn, was that although there was disagreement between the studies as to what blood results are affected positively, exercise is generally beneficial for these patients and has no significant adverse effects. However, various gaps in literature were identified and recommendations mainly focused on the need for further research, local studies, the development of an exercise program and policy, engaging exercise specialists and promotion of education for staff and patients.