Evidence map›Paper›PMID 30726242›Full record

SynthesisPloS one2019

The effect of exercise on blood pressure in chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials.

Stephanie Thompson, Natasha Wiebe, Raj S Padwal, Gabor Gyenes, Samuel A E Headley, Jeyasundar Radhakrishnan, Michelle Graham

Erratum issuedOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 31 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 5 pooled it
5.5field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 5 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
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  5. Pooled it
  6. Observational
  7. Management of hypertension in chronic kidney disease.Clinical medicine (London, England) · 2026
    Review
  8. Review
  9. Review
  10. Article
  11. Physical Exercise: A Promising Treatment Against Organ Fibrosis.International journal of molecular sciences · 2025
    Review
  12. Article
  13. Review
  14. Review
  15. Review
  16. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Stephanie ThompsonDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada.ORCID 0000-0003-3109-6837
Natasha WiebeDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada.
Raj S PadwalDepartment of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Gabor GyenesDepartment of Medicine, Division of Cardiology Mackenzie Health Science Centre, Edmonton, AB, Canada.
Samuel A E HeadleyDepartment of Exercise Science and Sport Studies, Springfield College, Springfield, MA, United States of America.
Jeyasundar RadhakrishnanInnovation Physical Therapy Edmonton, Alberta, Canada.
Michelle GrahamDepartment of Medicine, Division of Cardiology Mackenzie Health Science Centre, Edmonton, AB, Canada.
University of Alberta · CASpringfield College · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesManagement of hypertension in chronic kidney disease (CKD) remains a major challenge. We conducted a systematic review to assess whether exercise is an effective strategy for lowering blood pressure in this population. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We searched MEDLINE, EMBASE, the Cochrane Library, CINAHL and Web of Science for randomized controlled trials (RCTs) that examined the effect of exercise on blood pressure in adults with non-dialysis CKD, stages 3-5. Outcomes were non-ambulatory systolic blood pressure (primary), other blood pressure parameters, 24-hour ambulatory blood pressure, pulse-wave velocity, and flow-mediated dilatation. Results were summarized using random effects models.

resultsTwelve studies with 505 participants were included. Ten trials (335 participants) reporting non-ambulatory systolic blood pressure were meta-analysed. All included studies were a high risk of bias. Using the last available time point, exercise was not associated with an effect on systolic blood pressure (mean difference, MD -4.33 mmHg, 95% confidence interval, CI -9.04, 0.38). The MD after 12-16 and 24-26 weeks of exercise was significant (-4.93 mmHg, 95% CI -8.83, -1.03 and -10.94 mmHg, 95% CI -15.83, -6.05, respectively) but not at 48-52 weeks (1.07 mmHg, 95% CI -6.62, 8.77). Overall, exercise did not have an effect on 24-hour ambulatory blood pressure (-5.40 mmHg, 95% CI -12.67, 1.87) or after 48-52 weeks (-7.50 mmHg 95% CI -20.21, 5.21) while an effect was seen at 24 weeks (-18.00 mmHg, 95% CI -29.92, -6.08). Exercise did not have a significant effect on measures of arterial stiffness or endothelial function.

conclusionLimited evidence from shorter term studies suggests that exercise is a potential strategy to lower blood pressure in CKD. However, to recommend exercise for blood pressure control in this population, high quality, longer term studies specifically designed to evaluate hypertension are needed.

Indexed as

Exercise TherapyBlood PressureBlood Pressure DeterminationExerciseHumansHypertensionPulse Wave AnalysisRandomized Controlled Trials as TopicRenal Insufficiency, ChronicTreatment Outcome

Identifiers

PMID30726242
PMCPMC6364898
OpenAlexW2913191278

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.