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BLOOD FLOW RESTRICTED EXERCISE DOSAGE FOR CHRONIC KIDNEY DISEASE UNDERGOING HEMODIALYSIS: A META-ANALYSIS PROPOSAL

Abstract

Alexander G. Kasari, Lauren C. Bates-Fraser, Erik D. Hanson, FACSM, Lee Stoner, FACSM. University of North Carolina at Chapel Hill, Chapel Hill, NC.

BACKGROUND: Chronic kidney disease (CKD) affects millions of adults. To combat CKD, patients will undergo hemodialysis treatment. Exercise prescription is a useful adjuvant therapy. However, as a function of hemodialysis and CKD risk factors, traditional exercise is not feasible for all patients. A potential alternative to standard exercise prescription is blood flow restricted exercise (BFR-E). BFR-E can be completed at lower intensity and duration than conventional exercise. However, the optimal BFR-E dosage (frequency, intensity, duration, and modality) is unknown. The objective of this meta-analysis is to determine which BFR-E optimally improves health outcomes in patients with CKD receiving hemodialysis. METHODS: Following PROSPERO registration, a systematic review and meta-analysis will be conducted. Articles will be identified through using electronic databases. Inclusion criteria includes: (i) adult patients (age: 18 years or older) from stage 1 of CKD (Glomerular filtration rate (GFR) > 90 mL/min) to stage 5 (GFR < 15 mL/min); (ii) patients undergoing home or in-center hemodialysis treatment and; (iii) randomized controlled trials incorporating BFR-E (either aerobic or resistance training) and control groups or cross-sectional study designs will be included. Patients performing BFR-E while undergoing peritoneal dialysis will be excluded. Studies will also be evaluated on their quality using the RoB2 Cochrane risk-of-bias tool. ANTICIPATED RESULTS: Investigating dosage of BFR-E will allow us to consolidate existing evidence of variable BFR-E protocols to fill a critical gap in the literature describing recommended intensity, frequency, duration, and modality of BFR-E. Research into BFR-E will shape recommendations for patients’ exercise regimens and help generate a strategic course of action to delay the progression of CKD.

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