Electronic Supplementary Material
Electronic Supplementary Material, Appendix S1. PubMed and Scopus search syntax
"kidney diseases"[MeSH Terms] OR kidney disease[Text Word] OR renal disease[Text
Word] OR "renal insufficiency, chronic"[MeSH Terms] OR "kidney failure, chronic"[MeSH
Terms] OR Chronic Renal Insufficiency[Text Word] OR End Stage Renal Disease[Text
Word] OR chronic renal disease[Text Word] OR end-stage renal failure[Text Word] OR
"renal dialysis"[MeSH Terms] OR renal dialysis[Text Word] OR "dialysis"[MeSH Terms]
OR
hemodialysis[Text
Word]
OR
haemodialysis[Text
Word]
AND
"resistance
training"[MeSH Terms] OR Resistance Training[Text Word] OR Strength Training[Text
Word]OR Resistance exercise [Text Word] OR "weight lifting"[MeSH Terms] OR weight
training [Text Word] OR Weight-lifting[Text Word] OR "weight-bearing"[MeSH Terms] OR
weight bearing[Text Word] OR Weight-bearing [Text Word] OR Resistance exercise
program*[text Word]
(TITLE-ABS-KEY("Resistance Training" OR "Strength Training" OR "Resistance exercise"
OR "weight lifting" OR "weight training" OR "weight bearing" OR "Resistance exercise
program*")) AND ((TITLE-ABS-KEY("kidney disease" OR "renal disease" OR "renal
insufficiency" OR "kidney failure" OR "chronic renal insufficiency" OR "end stage renal
disease" OR "end stage renal failure" OR "end stage kidney disease" OR "chronic kidney
disease") OR TITLE-ABS-KEY("renal dialysis" OR "renal Failure" OR *modialysis OR
dialysis OR CKD))
1
Electronic Supplementary Material, Table S1. Estimated Pre-post Correlations
Outcome
Change in muscle mass
Paper
Treatment group
Control group
Castaneda et al, 2001 [30]
0.95
0.91
Johansen et al, 2006a [26]
0.97
0.94
Johansen et al, 2006b [26]
0.99
0.97
Song et al, 2012
Change in knee extension
strength
quality of life (HRQoL)
[32]
0.96
0.98
Johansen et al, 2006a
[26]
0.81
0.70
Johansen et al, 2006b
[26]
0.74
0.63
0.89
0.91
0.87
0.78
0.94
0.96
0.90
0.89
0.66
0.68
Song et al, 2012
Change in health-related
Computed correlation
[32]
[26]
Johansen et al, 2006a
Johansen et al, 2006b [26]
Cheema et al, 2007 [27]
Song et al, 2012 [32]
2
Electronic Supplementary Material, Appendix S2. Excluded citations
1.
Afshar R, Shegarfy L, Shavandi N, Sanavi S: Effects of aerobic exercise and resistance
training on lipid profiles and inflammation status in patients on maintenance
hemodialysis. Indian Journal of Nephrology 2010, 20(4):185-189.
2.
Balakrishnan VS, Rao M, Menon V, Gordon PL, Pilichowska M, Castaneda F,
Castaneda-Sceppa C: Resistance training increases muscle mitochondrial biogenesis in
patients with chronic kidney disease. Clinical journal of the American Society of
Nephrology : CJASN 2010, 5(6):996-1002.
3.
Bullani R, El-Housseini Y, Giordano F, Larcinese A, Ciutto L, Bertrand PC, Wuerzner
G, Burnier M, Teta D: Effect of intradialytic resistance band exercise on physical
function in patients on maintenance hemodialysis: a pilot study. Journal of renal
nutrition : the official journal of the Council on Renal Nutrition of the National Kidney
Foundation 2011, 21(1):61-65.
4.
Castaneda C, Gordon PL, Parker RC, Uhlin KL, Roubenoff R, Levey AS: Resistance
training to reduce the malnutrition-inflammation complex syndrome of chronic kidney
disease. American journal of kidney diseases : the official journal of the National
Kidney Foundation 2004, 43(4):607-616.
5.
Cheema B, Abas H, Smith B, O'Sullivan A, Chan M, Patwardhan A, Kelly J, Gillin A,
Pang G, Lloyd B et al: Randomized controlled trial of intradialytic resistance training to
target muscle wasting in ESRD: The progressive exercise for anabolism in kidney
disease (PEAK) study. American Journal of Kidney Diseases 2007, 50(4):574-584.
6.
Cheema BS, Abas H, Smith BC, O'Sullivan AJ, Chan M, Patwardhan A, Kelly J, Gillin
A, Pang G, Lloyd B et al: Effect of resistance training during hemodialysis on
circulating cytokines: a randomized controlled trial. Eur J Appl Physiol 2011,
111(7):1437-1445.
3
7.
Copley JB: Resistance training enhances the value of protein restriction in the treatment
of chronic kidney disease. Ann Intern Med 2001, 135(11):999-1001.
8.
Headley S, Germain M, Mailloux P, Mulhern J, Ashworth B, Burris J, Brewer B, Nindl
BC, Coughlin M, Welles R et al: Resistance training improves strength and functional
measures in patients with end-stage renal disease. American journal of kidney diseases :
the official journal of the National Kidney Foundation 2002, 40(2):355-364.
9.
Heiwe S, Clyne N, Tollbäck A, Borg K: Effects of regular resistance training on muscle
histopathology and morphometry in elderly patients with chronic kidney disease.
American Journal of Physical Medicine and Rehabilitation 2005, 84(11):865-874.
10.
Kopple JD, Wang H, Casaburi R, Fournier M, Lewis MI, Taylor W, Storer TW:
Exercise in maintenance hemodialysis patients induces transcriptional changes in genes
favoring anabolic muscle. Journal of the American Society of Nephrology 2007,
18(11):2975-2986.
11.
Leaf DA, Macrae HSH, Grant E, Kraut J: Isometric exercise increases the size of
forearm veins in patients with chronic renal failure. American Journal of the Medical
Sciences 2003, 325(3):115-119.
12.
Majchrzak KM, Pupim LB, Flakoll PJ, Ikizler TA: Resistance exercise augments the
acute anabolic effects of intradialytic oral nutritional supplementation. Nephrology,
dialysis, transplantation : official publication of the European Dialysis and Transplant
Association - European Renal Association 2008, 23(4):1362-1369.
13.
Molsted S, Harrison AP, Eidemak I, Andersen JL: The Effects of High-Load Strength
Training With Protein- or Nonprotein-Containing Nutritional Supplementation in
Patients Undergoing Dialysis. Journal of Renal Nutrition 2013, 23(2):132-140.
14.
Nindl BC, Headley SA, Tuckow AP, Pandorf CE, Diamandi A, Khosravi MJ, Welles R,
Jones M, Germain M: IGF-I system responses during 12 weeks of resistance training in
4
end-stage renal disease patients. Growth hormone & IGF research : official journal of
the Growth Hormone Research Society and the International IGF Research Society
2004, 14(3):245-250.
15.
Segura-Ortí E, Kouidi E, Lisón JF: Effect of resistance exercise during hemodialysis on
physical function and quality of life: Randomized controlled trial. Clinical Nephrology
2009, 71(5):527-537.
16.
Segura-Orti E, Rodillo-Alama V, Lison JF: Physiotherapy during hemodialysis: results
of a progressive resistance-training programa. Nefrologia 2008, 28(1):67-72.
5
Electronic Supplementary Material, Table S2. Quality items checklist for randomized controlled trials
Study identification
Treatment Allocation (each worth 0.5
points): (1) evidence of randomization
method; (2) evidence of concealment of
treatment allocation
Were groups similar at baseline
regarding the most important
prognostic indicators?
Were the eligibility
criteria specified?
Were outcomes assessors
blinded?
Was compliance to the
intervention
reported?
Castaneda et al, 2001
0.5
1.0
1.0
0.5
1.0
Johansen et al, 2006
1.0
1.0
1.0
0.0
1.0
Cheema et al, 2007
1.0
1.0
1.0
0.5
1.0
Chen et al, 2010
1.0
1.0
1.0
0.0
1.0
Dong et al, 2011
0.5
1.0
1.0
0.0
1.0
Song et al, 2012
0.5
1.0
1.0
0.5
1.0
de Lima et al, 2013
1.0
1.0
1.0
0.0
0.0
(continued >>>)
Were exercise sessions
supervised (0.5 for
partial supervision)
Were dropouts
reported?
Were data presented for
primary and secondary
outcome measures?
Did the analysis
include an intention
to treat analysis?
Were adverse
events reported?
Total quality
score (out of
10)
1.0
1.0
1.0
0.0
1.0
8.0
1.0
1.0
1.0
0.0
1.0
8.0
1.0
1.0
1.0
1.0
1.0
9.5
1.0
1.0
1.0
0.0
1.0
8.0
1.0
1.0
1.0
0.0
0.0
6.5
1.0
1.0
1.0
0.0
1.0
8.0
0.5
1.0
1.0
0.0
0.0
5.5
(<<<continued)
6
Electronic Supplementary Material, Figure S1. Funnel plot assessing the symmetry of the standardized mean difference in muscular
strength outcomes between the treatment and control groups
.2
.3
.4
se(SMD)
.1
0
Funnel plot with pseudo 95% confidence limits
0
.5
1
SMD
1.5
2
7
Electronic Supplementary Material, Figure S2. Funnel plot assessing the symmetry of the standardized mean difference in total body
muscle mass between the treatment and control groups
.2
.3
.4
.5
se(SMD)
.1
0
Funnel plot with pseudo 95% confidence limits
-1
-.5
0
.5
1
1.5
SMD
8
Electronic Supplementary Material, Table S3. Sensitivity analysis of randomized controlled trials investigating total body muscle mass
outcomes
N studies
N sample
SMD
LCL
UCL
P-value
I2
p-value
Fixed effects model
6
200
0.34
0.05
0.63
0.02
73.5
0.002
Exclusion of 1 study of lower quality (score <6.0)
6
200
0.29
-0.27
0.86
0.311
73.5
0.002
Exclusion of 1 study involving PRT + nandrolone decanoate
5
168
0.38
-0.28
1.03
0.26
76
0.002
Exclusion of 2 studies in cohorts >60 yr
4
130
0.01
-0.74
0.76
0.98
77.1
0.004
Exclusion of 1 study in South Korea (and measuring BIA)
5
160
0.14
-0.46
0.74
0.651
71
0.008
Exclusion of 1 study in non-dialysis CKD
5
174
0.17
-0.46
0.79
0.602
75.4
0.003
Exclusion of 2 studies on PRT + diet
4
152
0.39
-0.17
0.96
0.171
66.2
0.031
Exclusion of 3 studies of longer duration
4
134
0.43
-0.2
1.06
0.18
68.8
0.022
Exclusion of 3 studies prescribing PRT during dialysis time
3
88
0.39
-0.78
1.56
0.515
84.9
0.001
SMD=standardized mean difference, LCL=lower confidence interval, UCL=upper confidence interval
9
Electronic Supplementary Material, Figure S3. Funnel plot assessing the symmetry of the standardized mean difference in lower body
muscle hypertrophy measures (i.e. leg mass, or mid-thigh or quadriceps CSA) between the treatment and control
.2
.4
.3
se(SMD)
.1
0
Funnel plot with pseudo 95% confidence limits
-.5
0
.5
SMD
1
1.5
groups
10
Electronic Supplementary Material, Figure S4. Funnel plot assessing the symmetry of the standardized mean difference in health-related
quality of life (HRQoL) outcomes between the treatment and control groups
.2
.3
.4
.5
se(SMD)
.1
0
Funnel plot with pseudo 95% confidence limits
0
.5
1
SMD
1.5
2
11