LITERATURE REVIEW : EFEKTIFITAS INTRADIALYTIC EXERCISE UNTUK PENGELOLAAN TEKANAN DARAH PADA PASIEN CHRONIC KIDNEY DISEASE (CKD)

Abstract

Several studies have reported a U-shaped association between systolic blood pressure and mortality risk in patients undergoing hemodialysis. One non-pharmacological approach for managing blood pressure in CKD patients undergoing hemodialysis is intradialytic exercise. Objective: To determine the effectiveness of intradialytic exercise in managing blood pressure in patients with Chronic Kidney Disease (CKD). Methods: This literature review employed a systematic approach to collect and analyze secondary data from relevant previous studies. The data were retrieved from both national and international journals using databases such as Google Scholar, PubMed, ProQuest, and ResearchGate, with publication years ranging from 2015 to 2025. A structured search strategy was used with Medical Subject Headings (MeSH) terms and Boolean operators (AND, OR). Inclusion and exclusion criteria were defined using the PICOS approach (Population, Intervention, Comparison, Outcome, Study Design) to ensure relevance and study quality. Literature selection followed the PRISMA flowchart, resulting in 10 studies eligible for further analysis out of an initial 3,492 articles. Results: Based on the ten reviewed studies, intradialytic exercise generally has a positive and significant effect on lowering blood pressure in patients with chronic kidney disease undergoing hemodialysis. This type of exercise has been shown to reduce both systolic and diastolic blood pressure, improve blood circulation, enhance cardiovascular function, and alleviate other symptoms such as fatigue, pain, and sleep disturbances. Conclusion: The review of ten journals concludes that intradialytic exercise may enhance peripheral blood flow, reduce vascular resistance, and stimulate parasympathetic nervous system activity, all of which contribute to lowering blood pressure.