운동 프로그램이 혈액투석 환자의 투석효율과 혈압에 미치는 효과

Abstract

This study attempted to identify the effects of exercise programs on dialysis efficiency and blood pressure in hemodialysis patients and to present empirical evidence through systematic literature review and network meta-analysis targeting domestic and foreign prior papers. In the literature search, 1824 articles were retrieved from databases such as PubMed, EMBASE, Cochrane Library, Web of Science, and RISS. Among them, 26 documents that met the selection criteria of this study were selected, and meta-analysis and network meta-analysis were performed based on them. The result was as follows. First, as a result of direct comparison meta-analysis, there was no significant effect on the dialysis efficiency of hemodialysis patients, but a significant effect on systolic and diastolic blood pressure. Second, as a result of analysis by subgroup, aerobic exercise was effective for improving dialysis efficiency and combined exercise was effective for systolic and diastolic blood pressure in the analysis by exercise type. Also, in the analysis by exercise duration an exercise program of fewer than 3 months in dialysis efficiency and an exercise program of 3 to 6 months in systolic and diastolic blood pressure had a significant effect. In the analysis according to exercise time, there was no significant effect on dialysis efficiency and a 30-60 minute exercise program had a significant effect on systolic and diastolic blood pressure. Third, as a result of network meta-analysis, aerobic exercise for dialysis efficiency and compound exercise for systolic/diastolic blood pressure had the highest probability of being the best exercise program and consistency was supported. Fourth, as a result of the network meta-analysis for each subgroup, in the analysis by exercise duration, aerobic exercise of less than 3 months for dialysis efficiency and 3~6 months of combined exercise for systolic and diastolic blood pressure had the highest probability of being the best exercise program. Also, in the analysis by exercise time, 30 to 60 minutes of aerobic exercise for dialysis efficiency and 30 to 60 minutes of combined exercise for systolic and diastolic blood pressure had the highest probability of being the best exercise program. In conclusion, in meta-analysis and network meta-analysis, aerobic exercise for less than 3 months and 30 to 60 minutes per session is effective for dialysis efficiency. For systolic and diastolic blood pressure, combined exercise for 3 to 6 months and 30 to 60 minutes per session was found to be the most effective. Therefore, the exercise program for the management of dialysis efficiency and blood pressure in hemodialysis patients in the future is based on this evidence, so that combined exercise including aerobic exercise for 30 minutes or more should be performed 3 times a week, 30 to 60 minutes per session, and 3 to 6 months. It would be best to set.