Network meta-analysis of exercise modalities for their effects on micro-inflammation in patients undergoing hemodialysis

作者：Lan‐Ping Xu, Xinyu Wang, Xiaoxia Cai, Yuan Lv, Li Ye, X Wang, Liqiao Chen · 发表于：European journal of medical research · 年份：2025 · DOI：10.1186/s40001-025-03280-1 · 被引用次数：1 · 研究领域：Dialysis and Renal Disease Management、Exercise and Physiological Responses、Cardiovascular and exercise physiology

AIMS: Exercise can effectively ameliorate the micro-inflammatory state in patients undergoing maintenance hemodialysis (MHD), but the optimal intervention modality remains unclear. This study systematically compared the anti-inflammatory efficacy of different exercise modalities by focusing on evaluating the levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). METHODS: A systematic search was conducted across the CNKI, VIP, Wanfang, China Biology Medicine disc (CBMdisc), PubMed, Web of Science, Embase, and Cochrane Library databases to identify randomized controlled trials investigating exercise interventions for micro-inflammatory state in MHD patients, from database inception to November 16, 2024. The Cochrane Risk of Bias Tool was employed to assess the methodological quality of the included studies. Data were analyzed using Stata 16.0 and Review Manager 5.3 software. RESULTS: A total of 41 RCTs involving 12 intervention modalities and 2939 patients were ultimately included. The network meta-analysis results demonstrated that, compared with usual care (UC), intradialytic resistance exercise combined with non-dialytic aerobic exercise (IRE + NAE) [SMD = - 1.78, 95% CI (- 3.06, - 0.5)] showed the most promising effect in improving CRP levels (SUCRA = 89.1%). Intradialytic aerobic exercise combined with non-dialytic aerobic exercise (IAE + NAE) [SMD = - 1.43, 95% CI (- 2.71, - 0.14)] exhibited the most promising efficacy in reducing I...