The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index; 10 of the 17 sources its claims cite were checked for support.
Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis
Open accessAbstract
Background: Patients with chronic kidney disease (CKD) have a high prevalence of cardiovascular diseases, which often lead to physical inactivity that correlates with CKD exacerbation. The benefits of regular exercise to cardiovascular health have been well established in healthy population and highly suggestive in patients with CKD. To further strengthen the evidence base for the management of CKD, this meta-analysis was performed to systematically evaluate the effects of exercise therapy on renal function, blood pressure, blood lipid and body mass index (BMI) in non-dialysis CKD patients. Methods: This meta-analysis was conducted following a previous protocol. Randomized controlled trials (RCTs) examining the effects of exercise therapy in non-dialysis CKD patients were searched in Pubmed, Embase, Cochrane Library, and three major Chinese biomedical databases (CNKI, WANGFANG and VIP) from their start date to October 30th, 2018. The Cochrane systematic review methods were applied for quality assessment and data extraction, and Revman version 5.3 was used for systematic review and meta-analysis. Results: 13 RCTs, representing 421 patients with non-dialysis CKD, were included in this meta-analysis. Compared to the controls, exercise therapy brought an increase in eGFR (MD = 2.62, 95% CI:0.42 to 4.82, P = 0.02, I 2 = 22%), and decreases in systolic blood pressure (SBP) (MD = -5.61, 95% CI:-8.99 to − 2.23, P = 0.001, I 2 = 44%), diastolic blood pressure (DBP) (MD = -2.87, 95% CI:-3.65 to − 2.08, P < 0.00001, I 2 = 16%) and BMI (MD = -1.32, 95% CI:-2.39 to − 0.25, P = 0.02, I 2 = 0%) in non-dialysis CKD patients. Exercise therapy of short-term (< 3 months) decreased triglyceride (TG) level ( P = 0.0006). However, exercise therapy did not significantly affect serum creatinine (SCr), total cholesterol (TC), high density lipoprotein (HDL) or low density lipoprotein (LDL) in non-dialysis CKD patients. Conclusion: Exercise therapy could benefit non-dialysis CKD patients by increasing eGFR while reducing SBP, DBP and BMI. Additionally, short-term intervention of exercise could decrease TG.
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Written from the paper’s full text.
TL;DR
This meta-analysis of 13 RCTs in non-dialysis CKD patients found that exercise therapy increased eGFR and reduced systolic blood pressure, diastolic blood pressure, and BMI. It did not significantly affect serum creatinine, total cholesterol, HDL, or LDL overall, though short-term exercise reduced triglycerides.
Key findings
- In 13 RCTs representing 421 non-dialysis CKD patients (experimental/control 212/209), exercise therapy increased eGFR (MD = 2.62, 95% CI 0.42–4.82, P = 0.02, I² = 22%); short-term exercise (<3 months) increased eGFR by 5.22 ml/min/1.73m² (MD = 5.22, 95% CI 0.68–9.77, P = 0.02), but 3–6 months and 6–12 months did not.
- Exercise reduced SBP by 5.61 mmHg (MD = -5.61, 95% CI -8.99 to -2.23, P = 0.001, I² = 44%), DBP by 2.87 mmHg (MD = -2.87, 95% CI -3.65 to -2.08, P < 0.00001, I² = 16%), and BMI (MD = -1.32, 95% CI -2.39 to -0.25, P = 0.02, I² = 0%); BMI reduction was significant with 6–12 months of exercise (MD = -2.27, 95% CI -3.84 to -0.70, P = 0.005) but not <6 months.
- Exercise did not significantly affect SCr (MD = -0.04, 95% CI -0.32 to 0.25, P = 0.79), TC (MD = 1.19, 95% CI -1.60 to 3.99, P = 0.40), HDL (MD = 0.17, 95% CI -0.17 to 0.51, P = 0.32), or LDL (MD = 2.79, 95% CI -1.73 to 7.32, P = 0.23).
- Short-term exercise (<3 months) decreased TG (MD = -94.79, 95% CI -148.81 to -40.76, P = 0.0006), while 3–12 months increased TG (MD = 45.87, 95% CI 17.82 to 73.92, P = 0.001).
Methods
- Systematic review and meta-analysis of RCTs; searched PubMed, Embase, Cochrane Library, CNKI, WANGFANG, and VIP from database start to October 30, 2018, for English or Chinese studies, following PRISMA and Cochrane methods; RevMan 5.3 used for analysis.
- Included adults >18 years with non-dialysis CKD stage 2–5 receiving aerobic and/or resistance exercise at least once weekly for more than one month, with outcomes including eGFR, blood pressure, or blood lipids; 13 RCTs with 421 participants were included.
- Continuous outcomes pooled as mean difference with 95% CI; heterogeneity assessed by χ² test and I²; fixed- or random-effects models used according to heterogeneity; subgroup analyses by exercise duration; sensitivity analysis by leave-one-out; publication bias assessed via funnel plots.
Limitations
- Stated by the authors: included RCT designs were not entirely uniform; randomization and methods were not clearly described; sample size was relatively small; exercise mode, intensity, and frequency were not completely consistent; studies could not be accurately classified by exercise therapy type, so such subgroup analysis was not performed.
- Evident from the text: participant counts are inconsistent across analyses (abstract reports 421 patients, while eGFR analysis reports 529 participants, SBP 463, DBP 399, and BMI 466), and high heterogeneity was present for SCr (I² = 72%), TG (I² = 78%), LDL (I² = 67%), and TC (I² = 54%).
- Evident from the text: performance bias was high in more than 75% of included RCTs because blinding participants and personnel is challenging in exercise trials, and publication bias was assessed only through funnel plot symmetry.
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Claims the paper makes
24 Own result · 16 Own method · 3 Own interpretation · 1 Supported · 1 Supported so far · 1 Partly supported · 1 Couldn’t confirm · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“high risk of performance bias was granted to more than 75% of the studies [7, 9, 10, 13, 15–18, 20, 21].”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > Quality assessment
What the sources say
- Not checked — no full text of the sourcecites [7] Aoike DT, Baria F, Kamimura MA, Ammirati A, de Mello MT, Cuppari L. Impact of home-based aerobic exercise on the physical capacity of overweight patients with chronic kidney disease. Int Urol Nephrol. 2015;47(2):359–67. source
- Partly supportedcites [9] Toyama K, Sugiyama S, Oka H, Sumida H, Ogawa H. Exercise therapy correlates with improving renal function through modifying lipid metabolism in patients with cardiovascular disease and chronic kidney disease. J Cardiol. 2010;56(2):142–6. sourceExperimental — accuracy not yet measured
The Methods section (page not provided) describes this study as an open-labeled clinical trial, which supports a concern about performance bias in this study. The paper does not assess performance bias across the citing document’s included studies or establish that more than 75% were rated high risk. (LLM, conf=0.84)
- Not checked — no full text of the sourcecites [10] Greenwood SA, Koufaki P, Mercer TH, MacLaughlin HL, Rush R, Lindup H, et al. Effect of exercise training on estimated GFR, vascular health, and cardiorespiratory fitness in patients with CKD: a pilot randomized controlled trial. Am J Kidney Dis. 2015;65(3):425–34. source
- Could not verifycites [13] Miele EM, Headley SAE, Germain M, Joubert J, Herrick S, Milch C, et al. High-density lipoprotein particle pattern and overall lipid responses to a short-term moderate-intensity aerobic exercise training intervention in patients with chronic kidney disease. Clin Kidney J. 2017;10(4):524–31. sourceExperimental — accuracy not yet measured
The Results describe one randomized exercise intervention, and the Materials and methods describe its procedures. Neither section assesses performance bias across the citing paper’s included studies or reports that more than 75% were rated high risk. Searches for performance bias, blinding, and the 75% figure found no such assessment in our copy. (LLM, conf=0.76)
- Supportedcites [15] Kiuchi MG, Chen S. The effect of the physical activity on polymorphic premature ventricular complexes in chronic kidney disease. Kidney Res Clin Pract. 2017;36(2):167–74. source
The citation identifies one of the studies the citing authors assessed, rather than attributing their aggregate performance-bias calculation to this paper. The Methods describe this prospective study of 40 patients, with 20 in an exercise group and 20 sedentary controls; the cited work is therefore a study of the kind being identified. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites [16] Leehey DJ, Collins E, Kramer HJ, Cooper C, Butler J, McBurney C, et al. Structured exercise in obese diabetic patients with chronic kidney disease: a randomized controlled trial. Am J Nephrol. 2016;44(1):54–62. source
- Not checked — no full text of the sourcecites [17] Van Craenenbroeck AH, Van Craenenbroeck EM, Van Ackeren K, Vrints CJ, Conraads VM, Verpooten GA, et al. Effect of moderate aerobic exercise training on endothelial function and arterial stiffness in CKD stages 3-4: a randomized controlled trial. Am J Kidney Dis. 2015;66(2):285–96. source
- Supportedcites [18] Baria F, Kamimura MA, Aoike DT, Ammirati A, Rocha ML, de Mello MT, et al. Randomized controlled trial to evaluate the impact of aerobic exercise on visceral fat in overweight chronic kidney disease patients. Nephrol Dial Transplant. 2014;29(4):857–64. source
The Study protocol describes a prospective randomized controlled exercise trial. In this sentence, the citation identifies one of the studies the citing authors assessed; the high-risk rating and the figure of more than 75% are the citing authors’ appraisal across studies, not findings attributed to this individual trial. (LLM, conf=0.85)
- Not checked — no full text of the sourcecites [20] Headley S, Germain M, Milch C, Pescatello L, Coughlin MA, Nindl BC, et al. Exercise training improves HR responses and V O2peak in predialysis kidney patients. Med Sci Sports Exerc. 2012;44(12):2392–9. source
- Supportedcites [21] Leehey DJ, Moinuddin I, Bast JP, Qureshi S, Jelinek CS, Cooper C, et al. Aerobic exercise in obese diabetic patients with chronic kidney disease: a randomized and controlled pilot study. Cardiovasc Diabetol. 2009;8:62. source
The citation identifies this paper as one of the studies assessed by the citing authors, rather than attributing their aggregate performance-bias judgment to the trial authors. The Methods > Study Design section describes it as a randomized controlled pilot study with exercise and control groups (page unavailable). (LLM, conf=0.84)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and MD = 0.19, 95% CI: − 0.16 to 0.53, P = 0.29 for those receiving 6–12 months of exercise therapy, respectively”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > The impact of exercise therapy on indexes of blood lipids
plainn = 372- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“DBP was decreased by 3.23 mmHg in subjects receiving less than 6 months of exercise therapy (MD = -3.23, 95% CI: − 5.53 to − 0.93, P = 0.006)”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > The impact of exercise therapy on indexes of blood pressure
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and by 2.82 mmHg (MD = -2.82, 95% CI: − 3.65 to − 1.98, P < 0.00001) in subjects receiving 6–12 months of exercise therapy”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > The impact of exercise therapy on indexes of blood pressure
plaindirectn = 399 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“or 6–12 months of exercise (MD = 2.69, 95% CI: − 0.62 to 6.00, P = 0.11).”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > The impact of exercise therapy on indexes of renal function
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, exercise therapy did not significantly affect serum creatinine (SCr), total cholesterol (TC), high density lipoprotein (HDL) or low density lipoprotein (LDL) in non-dialysis CKD patients.”
- Also stated in: § The impact of exercise therapy on indexes of blood lipids · plain
“no significant difference was found in LDL level between the experimental and the control groups (MD = 2.79, 95% CI: − 1.73 to 7.32, P = 0.23)”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Abstract > Results
plainn = 394- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § The impact of exercise therapy on indexes of blood lipids · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“decreases in systolic blood pressure (SBP) (MD = -5.61, 95% CI:-8.99 to − 2.23, P = 0.001, I2 = 44%)”
- Also stated in: § The impact of exercise therapy on indexes of blood pressure · hedged
“Meta-analysis using the random effect model showed that exercise therapy could markedly reduce SBP by 5.61 mmHg (MD = -5.61, 95% CI: − 8.99 to − 2.23, P = 0.001) in non-dialysis CKD patients.”
- Also stated in: § Discussion · boosted
“Our meta-analysis confirms that exercise therapy reduces SBP by 5.61 mmHg and DBP by 2.87 mmHg in stage 2–5 non-dialysis CKD patients.”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Abstract > Results
boosteddirectn = 463 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § The impact of exercise therapy on indexes of blood pressure · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“but not with 3–6 months of exercise (MD = 0.65, 95% CI: − 3.20 to 4.51, P = 0.74)”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > The impact of exercise therapy on indexes of renal function
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, exercise therapy did not significantly affect serum creatinine (SCr), total cholesterol (TC), high density lipoprotein (HDL) or low density lipoprotein (LDL) in non-dialysis CKD patients.”
- Also stated in: § The impact of exercise therapy on indexes of renal function · plain
“we found that there was no significant difference in Scr between the intervention and the control groups (MD = -0.04, 95% CI: − 0.32 to 0.25, P = 0.79).”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Abstract > Results
plainn = 271- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § The impact of exercise therapy on indexes of renal function · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared to the controls, exercise therapy brought an increase in eGFR (MD = 2.62, 95% CI:0.42 to 4.82, P = 0.02, I2 = 22%)”
- Also stated in: § The impact of exercise therapy on indexes of renal function · hedged
“Our results showed that exercise intervention could bring an average increase of 2.62 ml/min/1.73m2 in eGFR in non-dialysis CKD patients, and the difference was statistically significant (MD = 2.62, 95% CI:0.42 to 4.82, P = 0.02).”
- Also stated in: § Discussion · hedged
“Furthermore, our meta-analysis showed that exercise therapy could increase eGFR by 2.62 ml/min/1.73m2 in non-dialysis CKD patients.”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Abstract > Results
plaindirectn = 529 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § The impact of exercise therapy on indexes of renal function · hedged
- Probably not a substantial claim. 11
- It may state two separate claims as one. 2
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Risk for detection bias was unclear in 4 RCTs [7, 13, 20, 21], and was scored as high in Kiuchi study only [15].”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > Quality assessment
What the sources say
- Not checked — no full text of the sourcecites [7] Aoike DT, Baria F, Kamimura MA, Ammirati A, de Mello MT, Cuppari L. Impact of home-based aerobic exercise on the physical capacity of overweight patients with chronic kidney disease. Int Urol Nephrol. 2015;47(2):359–67. source
- Supportedcites [13] Miele EM, Headley SAE, Germain M, Joubert J, Herrick S, Milch C, et al. High-density lipoprotein particle pattern and overall lipid responses to a short-term moderate-intensity aerobic exercise training intervention in patients with chronic kidney disease. Clin Kidney J. 2017;10(4):524–31. source
The Materials and methods (Procedures; page unavailable) identifies this study as a randomized exercise-versus-control comparison. Its Procedures and Biochemical analyses describe outcome measurement without stating whether outcome assessors were blinded, consistent with an unclear detection-bias rating for this study. The other three RCTs and the Kiuchi rating are attributed to other citations in the sentence, not to this paper. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [20] Headley S, Germain M, Milch C, Pescatello L, Coughlin MA, Nindl BC, et al. Exercise training improves HR responses and V O2peak in predialysis kidney patients. Med Sci Sports Exerc. 2012;44(12):2392–9. source
- Supportedcites [21] Leehey DJ, Moinuddin I, Bast JP, Qureshi S, Jelinek CS, Cooper C, et al. Aerobic exercise in obese diabetic patients with chronic kidney disease: a randomized and controlled pilot study. Cardiovasc Diabetol. 2009;8:62. source
The citation identifies one of the RCTs assessed by the citing authors, rather than attributing their detection-bias rating to the trial authors. The Methods > Study Design passage identifies this paper as a randomized controlled pilot study. The four-study count and the rating of the Kiuchi study are not claims made by this source. (LLM, conf=0.86)
- Supportedcites [15] Kiuchi MG, Chen S. The effect of the physical activity on polymorphic premature ventricular complexes in chronic kidney disease. Kidney Res Clin Pract. 2017;36(2):167–74. source
The citation identifies the Kiuchi study being assessed, not a risk-of-bias rating made by Kiuchi and Chen. The Methods section describes that study and its comparison of exercise plus β blocker with β blocker alone; the high-risk score is the citing authors’ own assessment. (LLM, conf=0.85)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“This meta-analysis was conducted following a previous protocol.”
- Also stated in: § Quality assessment · plain
“Following our previously published protocol [12]”
- Also stated in: § Statistical analysis · plain
“Statistical analyses were carried out according to a previous published plan [12].”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Abstract > Methods
What the sources say
- Could not verifycites [12] Wang Y, Yang S, Zhou Q, Zhang H, Yi B. Effects of vitamin D supplementation on renal function, inflammation and glycemic control in patients with diabetic nephropathy: a systematic review and Meta-analysis. Kidney Blood Press Res. 2019;44(1):72–87. sourceExperimental — accuracy not yet measured
The Literature search strategy and Quality assessment sections describe how the meta-analysis was conducted, but neither says it followed a previously published protocol. Searches for “previous protocol,” “published protocol,” and “PROSPERO” found no passage establishing that point in our copy. (LLM, conf=0.72)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Quality assessment · plain
Every source the paper cites for this claim was checked and supports it.
In the paper
“This systematic search and meta-analysis was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [11] and checklist (Additional file 1: Checklist).”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Materials and methods > Inclusion criteria
What the sources say
- Supportedcites [11] Moher D, Liberati A, Tetzlaff J. Altman DG; PRISMA group. Preferred reporting items for systematic reviews and Meta-analyses: the PRISMA statement. Open Med 2009;3(3):123-30 . source
The PRISMA Statement section identifies the source as the PRISMA reporting guidance for systematic reviews and meta-analyses and describes its checklist and flow diagram. The citation supports identification of the guidelines; it does not independently verify the citing authors’ claim that they followed them. (LLM, conf=0.92)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“our literature collection was comprehensive”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Some experimental designs and methods, such as randomization, were not clearly described.”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The literature search was conducted by two of the authors (L.Z. and Y.W.) independently.”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Materials and methods > Literature search strategy
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Only randomized controlled trials (RCTs) were included.”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Materials and methods > Inclusion criteria
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The literatures included in this meta-analysis could not be accurately classified according to the types of exercise therapy and such subgroup analysis was not performed.”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The Cochrane systematic review methods were applied for quality assessment and data extraction”
- Also stated in: § Quality assessment · plain
“According to the Cochrane Collaboration for Systematic Reviews of Interventions, the following guidelines were applied to assess all included RCTs”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Abstract > Methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Quality assessment · plain
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“two researchers (L.Z. and Y.W.) performed quality assessment of the selected RCTs independently.”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Materials and methods > Quality assessment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Quantitative data were extracted from the included articles independently by two authors (L.Z. and Y.W.)”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Materials and methods > Data extraction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“subgroup analysis was carried out based on the duration of exercise intervention to ensure the reliability of the research results.”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
The included RCTs are representative of the broader non-dialysis CKD patient population, so the pooled effects can be generalized to all non-dialysis CKD patients.
“Exercise therapy could benefit non-dialysis CKD patients by increasing eGFR while reducing SBP, DBP and BMI.”
“exercise therapy may be a potential strategy to improve eGFR, reduce SBP, DBP and BMI in non-dialysis CKD patients.”
The paper relies on this without support.
Improvements in eGFR, SBP, DBP, and BMI from exercise therapy translate into clinical benefit for non-dialysis CKD patients.
“Exercise therapy could benefit non-dialysis CKD patients by increasing eGFR while reducing SBP, DBP and BMI.”
“exercise therapy may be a potential strategy to improve eGFR, reduce SBP, DBP and BMI in non-dialysis CKD patients.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > Summary of literature search and study selection
“eGFR estimated glomerular filtration rate (According to MDRD formula).”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > The impact of exercise therapy on indexes of renal function
“eGFR was calculated using the CKD-EPI creatinine equation [7, 10, 15, 18] or the MDRD formula [8, 9, 13, 14, 16, 17, 20, 21].”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Discussion
“This anti-hypertensive effect is specifically significant in participants who received exercise therapy of less than 6 months.”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > The impact of exercise therapy on indexes of blood pressure
“by 4.55 mmHg (MD = -4.55, 95% CI: − 8.20 to − 0.90, P = 0.01) in those who received exercise therapy of 6–12 months”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Background
“Aoike et al. evaluated the effects of aerobic training on overweight non-dialysis-dependent CKD patients, and found that exercise improved blood pressure (BP), but not renal function or body mass index (BMI) in these patients [7].”
§ Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis > Results > Summary of literature search and study selection
“Decreased blood pressure and improved renal function”
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Metadata
- Authors
- Zhang, L., Wang, Y., Xiong, L., Luo, Y., Huang, Z., & Yi, B.
- Affiliations
- Central South University (CN)
- Corresponding author
- Yi, Bin
- Venue
- BMC Nephrology
- Published
- 2019-10-29
- Volume
- 20
- Issue
- 1
- Pages
- 398-398
- ISSN
- 1471-2369 (ISSN-L)
- PMC
- PMC6821004
- OpenAlex
- W2982354070
- Cited by
- 132
- References
- 34
- Citations by year
- 2026: 15 · 2025: 18 · 2024: 27 · 2023: 18 · 2022: 21 · 2021: 24 · 2020: 8
- FWCI
- 2.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Nephrology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (submittedVersion, cc-by)
- PubMed Central (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- the New Xiangya Talent of Third Xiangya Hospital of Central South University (20160309)
- the Scientific Research Project of Health and Family Planning Commission of Hunan Province (B20180194)
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- exercise therapy, chronic kidney disease, predialysis, estimated glomerular filtration rate, blood pressure, body mass index, serum lipids, triglycerides, serum creatinine, total cholesterol, HDL cholesterol, physical inactivity, cardiovascular risk, renal function, exercise intensity, exercise frequency, exercise mode
- MeSH terms
- Blood Pressure, Cholesterol, Creatinine, Exercise Therapy, Glomerular Filtration Rate, Humans, Kidney, Lipoproteins, HDL, Lipoproteins, LDL, Triglycerides, Body Mass Index, Randomized Controlled Trials as Topic, Uncertainty, Renal Insufficiency, Chronic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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