Effects of Physical Exercise on Inflammatory Biomarkers in patients with Chronic Kidney Disease: A Meta-Analysis

Abstract

Chronic Kidney Disease (CKD) is found to be associated with systemic inflammation with increased levels of inflammatory biomarkers which increases the risk of cardiovascular events in these patients. This systematic review and meta-analysis was done to assess the effects of exercise on inflammatory biomarkers in patients with CKD. PubMed, Google Scholar, Scopus and PEDro databases were systematically searched. All published articles till March 2023 were included in this review. Of the articles retrieved 15 were included in qualitative analysis and among them 9 were quantitatively analysed. Included studies were of fair and good quality on PEDro rating scale. Cochrane Collaboration tool of risk of bias was used to assess the risk of bias. Results of the analysis suggested that exercise is effective in lowering the level of inflammatory C-reactive protein (CRP) level. The result was statistically significant (mean difference = -1.51, 95% CI: -2.23 to -0.79, I2= 71%, p-value 0.004). For tumour necrosis factor (TNF- α) the differences were found statistically significant (mean difference = -0.67, 95 % CI: -1.31 to -0.03, I2= 81%, p-value <0.001). For Interleukins (IL) -6 the result was statistically significant (mean difference = -0.68, 95% CI: -1.74 to 0.37, I2= 61%, p-value <0.001). For IL-10 the result was statistically significant (mean difference = 1.80, 95% CI: 0.18, 3.42, I2= 95%, p-value <0.001). It is concluded that various exercises like aerobic training, resistance training and inspiratory muscle training balance training have a significant effect on reducing the inflammation in patient with CKD thereby helps reducing cardiac.

Keywords

• Aerobic Exercise
• Biomarkers
• Chronic Renal Insufficiency
• Exercise
• Inflammation
• Resistance