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      The impact of exercise intervention for patients undergoing hemodialysis on fatigue and quality of life : A protocol for systematic review and meta-analysis

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          Abstract

          Background:

          This study aims to determine the therapeutic efficacy of exercise interventions for patients undergoing hemodialysis (HD) on fatigue and health-related quality of life (HRQoL).

          Methods:

          This review will only include randomized controlled trials (RCTs). The search strategy will be performed in 4 English databases, 4 Chinese databases, Clinical Trials.gov, and the Chinese Clinical Trial Registry. All English or Chinese RCTs, published from inception to May 31, 2020, will be sought. Two reviewers will screen, select studies, extract data, and assess quality independently. Primary outcome is fatigue assessed by questionnaire. The methodological quality including the risk of bias of the included studies will be evaluated using the Physiotherapy Evidence Database scale. Stata 12.0 software will be used for heterogeneity assessment, generating funnel-plots, data synthesis, subgroup analysis, and sensitivity analysis.

          Results:

          We will provide some more practical and targeted results investigating the effect of exercise interventions for patients undergoing HD on fatigue and HRQoL in the current meta-analysis, and point out the main limitation of previous studies.

          Conclusion:

          The study will provide recent evidence for evaluating the therapeutic efficacy of exercise interventions for patients undergoing HD on fatigue and HRQoL.

          Registration number:

          INPLASY202050071 (DOI: 10.37766/inplasy2020.5.0071)

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          Most cited references18

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          Fatigue: a concept analysis.

          Fatigue is probably the most common symptom of illness affecting sufferers of both acute and chronic conditions. However, confusion surrounds the definition and use of the term fatigue. As with many other nursing concepts, it is a word that is commonly used in colloquial language. This concept analysis aims to identify the attributes that are essential to the concept of fatigue, and to distinguish between its colloquial and its nursing usage by following the strategy suggested by Walker and Avant (1995, Strategies for Theory Construction in Nursing, Appleton Lange, London). A review of the literature identifies nursing uses of the term fatigue which reflect and conflict with colloquial uses. Defining attributes, demonstration cases, antecedents, consequences and empirical referents are identified before a definition of fatigue is developed and proposed for nursing. This clarification of the phenomenon has particular relevance for clinical nursing, future research and the development of fatigue theories.
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            Fatigue in patients receiving maintenance dialysis: a review of definitions, measures, and contributing factors.

            Fatigue is a debilitating symptom or side effect experienced by many patients on long-term dialysis therapy. Fatigue has a considerable effect on patient health-related quality of life and is viewed as being more important than survival by some patients. Renal providers face many challenges when attempting to reduce fatigue in dialysis patients. The lack of a reliable, valid, and sensitive fatigue scale complicates the accurate identification of this symptom. Symptoms of daytime sleepiness and depression overlap with fatigue, making it difficult to target specific therapies. Moreover, many chronic health conditions common in the long-term dialysis population may lead to the development of fatigue and contribute to the day-to-day and diurnal variation in fatigue in patients. Key to improving the assessment and treatment of fatigue is improving our understanding of potential mediators, as well as potential therapies. Cytokines have emerged as an important mediator of fatigue and have been studied extensively in patients with cancer-related fatigue. In addition, although erythropoietin-stimulating agents have been shown to mitigate fatigue, the recent controversy regarding erythropoietin-stimulating agent dosing in patients with chronic kidney disease suggests that erythropoietin-stimulating agent therapy may not serve as the sole therapy to improve fatigue in this population. In conclusion, fatigue is an important and often underrecognized symptom in the dialysis population. Possible interventions for minimizing fatigue in patients on long-term dialysis therapy should aim at improving health care provider awareness, developing improved methods of measurement, understanding the pathogenesis better, and managing known contributing factors.
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              Executive summary for the 2015 Annual Data Report of the China Kidney Disease Network (CK-NET)

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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                17 July 2020
                17 July 2020
                : 99
                : 29
                : e21394
                Affiliations
                [a ]Department of Nephrology
                [b ]Shanghai University of Traditional Chinese Medicine
                [c ]Department of Nursing, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
                Author notes
                []Correspondence: Fan Zhang, NO. 725 Wanping South Road, Xuhui District, Shanghai 200032, China (e-mail: 1051071914@ 123456qq.com ).
                Author information
                http://orcid.org/0000-0003-4692-0526
                Article
                MD-D-20-04973 21394
                10.1097/MD.0000000000021394
                7373554
                32702938
                78cff5ad-49b5-4ad1-97dc-f5224f76c2f8
                Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 22 June 2020
                : 23 June 2020
                Funding
                Funded by: Postgraduate innovation training program
                Award ID: Teaching 439
                Award Recipient : Not Applicable
                Categories
                5200
                Research Article
                Study Protocol Systematic Review
                Custom metadata
                TRUE

                hemodialysis,exercise,systematic review,fatigue,health-related quality of life

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