营养补充结合运动训练对慢性肾病患者虚弱、身体功能和生活质量的影响：系统回顾和荟萃分析

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition Pub Date : 2025-03-01 DOI:10.1053/j.jrn.2024.11.009

Fan Zhang , Hui Wang , Yan Bai , Liuyan Huang , Huachun Zhang

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引用次数: 0

摘要

目的：营养补充和运动训练的联合干预策略有可能支持慢性肾脏疾病（CKD）患者虚弱的治疗和改善健康结果。本研究旨在评估营养补充结合运动训练干预对CKD患者虚弱特征、身体功能和健康相关生活质量的有效性。设计与方法：检索PubMed、Embase、Web of Science和Scopus，检索时间为成立至2022年10月22日，更新时间为2023年5月。一项随机对照试验（RCT）将营养补充结合运动训练与常规护理/单一营养补充或运动训练进行比较，以评估对CKD患者弗里德基础虚弱特征和身体功能的影响。两位作者独立选择文献，提取数据，并使用Cochrane偏倚风险工具2评估偏倚风险。使用hartung - knap - sidik - jonkman方法的随机效应模型或使用受限最大似然的固定效应模型对结果进行分析。采用“留一”法进行敏感性分析。结果：纳入7篇文章（9项试验，共324例患者）。荟萃分析显示，营养补充结合运动训练干预可以改善透析患者的虚弱特征，如步行速度（平均差值（MD）： 0.09 m/s, 95%（置信区间）CI 0.02至0.16），身体功能，如心肺功能（标准化平均差值（SMD）： 0.56, 95% CI 0.20至0.93），以及通过timed up and go测试评估的下肢活动能力（MD: -1.11 s, 95% CI -1.79至-0.43）。然而，联合干预对体重（MD: 1.28 kg, 95% CI -2.06 - 4.62）、疲劳（SMD: 0.57, 95% CI -1.44 - 0.30）和健康相关生活质量等其他指标的影响尚不确定。由于纳入研究的异质性和相对较小的样本量，这些结果应谨慎解释。结论：营养补充与运动训练相结合的干预策略可能有助于改善CKD患者的虚弱和身体功能，特别是步行速度、心肺健康和下肢活动能力。未来的研究应侧重于更大的样本量和长期随访，以证实这些初步发现，并探讨对其他健康指标的潜在影响。

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Effects of Nutritional Supplementation Combined With Exercise Training on Frailty, Physical Function, and Quality of Life in Chronic Kidney Disease: A Systematic Review and Meta-Analysis

This review evaluates the effectiveness of nutritional supplementation combined with exercise training on frailty characteristics, physical function, and health-related quality of life in patients with chronic kidney disease (CKD). A systematic search of PubMed, Embase, Web of Science, and Scopus was conducted, identifying 7 articles (9 trials, 324 patients). Meta-analysis showed that combined interventions improved frailty characteristics, such as walking speed (mean difference: 0.09 m/s, 95% confidence interval (CI): 0.02 to 0.16) and physical functioning, including cardiorespiratory fitness (standardized mean difference: 0.56, 95% CI: 0.20 to 0.93) and lower extremity mobility (Timed Up and Go test: -1.11 s, 95% CI: −1.79 to -0.43). However, effects on body weight, fatigue, and health-related quality of life remain uncertain. Due to study heterogeneity and small sample sizes, findings should be interpreted cautiously. Larger, long-term studies are needed to confirm these results and explore additional health outcomes.

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来源期刊

Journal of Renal Nutrition 医学-泌尿学与肾脏学

CiteScore

5.70

自引率

12.50%

发文量

146

审稿时长

6.7 weeks

期刊介绍： The Journal of Renal Nutrition is devoted exclusively to renal nutrition science and renal dietetics. Its content is appropriate for nutritionists, physicians and researchers working in nephrology. Each issue contains a state-of-the-art review, original research, articles on the clinical management and education of patients, a current literature review, and nutritional analysis of food products that have clinical relevance.