Protocolos de rehabilitación mediante ejercicio y métodos para la evaluación de la función física y calidad de vida en pacientes sometidos a diálisis peritoneal: una revisión sistemática

Abstract

Introduction

End-stage kidney disease (ESKD) impairs quality of life and requires renal replacement therapies such as peritoneal dialysis (PD). Although exercise has shown benefits, evidence regarding exercise protocols and evaluation methods in this population remains limited. The aim of this systematic review was to synthesize the characteristics of exercise protocols and the methods used to assess physical function, quality of life, and other clinical outcomes in patients with ESKD undergoing PD.

Methods

A systematic review was conducted using PubMed, ScienceDirect, PEDro, Web of Science, and EBSCO, including studies in adults undergoing PD with exercise interventions =4 weeks. The review was reported according to the PRISMA 2020 statement, and risk of bias was assessed using RoB 2.

Results

Of 347 records identified, 7 studies (n = 249 patients) were included. Interventions were predominantly 12 weeks long, with 2–5 weekly sessions of endurance, resistance, or combined training, delivered through supervised or telerehabilitation modalities. Intensity ranged from light to moderate (40–85% HRmax), and session duration varied between 25 and 60 minutes. Progression was poorly reported. Physical function tests and quality of life questionnaires (KDQOL-36, SF-36) were commonly used. All studies presented a high overall risk of bias.

Conclusions

There is substantial heterogeneity in exercise protocols and evaluation methods in patients with ESKD undergoing PD. This variability, along with the high risk of bias, limits the generalizability of findings and highlights the need for more rigorous, standardized, and comparable protocols, including telerehabilitation strategies.