Effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis: a systematic review and meta-analysis

Objective This study aims to evaluate the effects of exercise therapy combined with nutritional intervention on muscle strength, muscle mass, and physical function in maintenance hemodialysis (MHD) patients with sarcopenia (SP) through a systematic review and meta-analysis.Methods We searched multip...

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Main Authors: Liping Zhang, Lijiao Yang, Xiaofei Wang, Dongliang Zhang
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2025.2492365
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author Liping Zhang
Lijiao Yang
Xiaofei Wang
Dongliang Zhang
author_facet Liping Zhang
Lijiao Yang
Xiaofei Wang
Dongliang Zhang
author_sort Liping Zhang
collection DOAJ
description Objective This study aims to evaluate the effects of exercise therapy combined with nutritional intervention on muscle strength, muscle mass, and physical function in maintenance hemodialysis (MHD) patients with sarcopenia (SP) through a systematic review and meta-analysis.Methods We searched multiple databases for RCTs published up to November 2024. Inclusion criteria: patients aged ≥18 with end-stage renal disease receiving MHD and diagnosed with SP; experimental group receiving combined exercise and nutrition intervention, and control group receiving either intervention alone; outcome measures including muscle strength, muscle mass, and physical function. Meta-analysis was performed using Stata 15.1.Results Nine high-quality RCTs involving 513 MHD-SP patients (256 experimental, 257 control) were included. The combined intervention group showed significantly greater improvements in handgrip strength (WMD = 3.78, 95% CI: 2.02–5.53), leg power score (WMD = 5.52, 95% CI: 1.47–9.58), skeletal muscle index (WMD = 0.82, 95% CI: 0.62–1.03), lean body mass (WMD = 2.53, 95% CI: 0.45–4.61), walking speed (WMD = 0.11, 95% CI: 0.01–0.22), 6-minute walk test (WMD = 41.37, 95% CI: 20.16–62.58), and 30-second sit-to-stand test (WMD = 3.37, 95% CI: 1.67–5.07). Heterogeneity analysis showed I2 ≤ 50% for all outcomes, indicating robust results. Sensitivity and publication bias analyses confirmed the reliability of the findings.Conclusion Combined exercise therapy and nutritional intervention significantly improve muscle strength, mass, and physical function in MHD patients with sarcopenia, offering important clinical benefits.
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spelling doaj-art-07aba5ca30c5412398eb9abd801d75422025-08-20T03:25:07ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492025-12-0147110.1080/0886022X.2025.2492365Effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis: a systematic review and meta-analysisLiping Zhang0Lijiao Yang1Xiaofei Wang2Dongliang Zhang3Department of Nephrology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Nephrology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, ChinaObjective This study aims to evaluate the effects of exercise therapy combined with nutritional intervention on muscle strength, muscle mass, and physical function in maintenance hemodialysis (MHD) patients with sarcopenia (SP) through a systematic review and meta-analysis.Methods We searched multiple databases for RCTs published up to November 2024. Inclusion criteria: patients aged ≥18 with end-stage renal disease receiving MHD and diagnosed with SP; experimental group receiving combined exercise and nutrition intervention, and control group receiving either intervention alone; outcome measures including muscle strength, muscle mass, and physical function. Meta-analysis was performed using Stata 15.1.Results Nine high-quality RCTs involving 513 MHD-SP patients (256 experimental, 257 control) were included. The combined intervention group showed significantly greater improvements in handgrip strength (WMD = 3.78, 95% CI: 2.02–5.53), leg power score (WMD = 5.52, 95% CI: 1.47–9.58), skeletal muscle index (WMD = 0.82, 95% CI: 0.62–1.03), lean body mass (WMD = 2.53, 95% CI: 0.45–4.61), walking speed (WMD = 0.11, 95% CI: 0.01–0.22), 6-minute walk test (WMD = 41.37, 95% CI: 20.16–62.58), and 30-second sit-to-stand test (WMD = 3.37, 95% CI: 1.67–5.07). Heterogeneity analysis showed I2 ≤ 50% for all outcomes, indicating robust results. Sensitivity and publication bias analyses confirmed the reliability of the findings.Conclusion Combined exercise therapy and nutritional intervention significantly improve muscle strength, mass, and physical function in MHD patients with sarcopenia, offering important clinical benefits.https://www.tandfonline.com/doi/10.1080/0886022X.2025.2492365Resistance trainingnutritional interventionhemodialysissarcopeniameta-analysisphysical function
spellingShingle Liping Zhang
Lijiao Yang
Xiaofei Wang
Dongliang Zhang
Effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis: a systematic review and meta-analysis
Renal Failure
Resistance training
nutritional intervention
hemodialysis
sarcopenia
meta-analysis
physical function
title Effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis: a systematic review and meta-analysis
title_full Effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis: a systematic review and meta-analysis
title_fullStr Effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis: a systematic review and meta-analysis
title_full_unstemmed Effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis: a systematic review and meta-analysis
title_short Effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis: a systematic review and meta-analysis
title_sort effect of nutritional intervention combined with resistance exercise on clinical indicators of patients with sarcopenia in maintenance hemodialysis a systematic review and meta analysis
topic Resistance training
nutritional intervention
hemodialysis
sarcopenia
meta-analysis
physical function
url https://www.tandfonline.com/doi/10.1080/0886022X.2025.2492365
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