Systematic literature review and meta-analysis by Wahida et al. 2023

Dear Editor,When reading the systematic review and meta-analysis “The effectiveness of intradialytic exercise in ameliorating fatigue symptoms in patients with chronic kidney failure undergoing hemodialysis: A systematic literature review and meta-analysis.” by Wahida et al. published in the Journal of Taibah University Medical Sciences¹ I noticed an inconsistency in the inclusion of an article in the meta-analysis that needs addressing.To summarise, the review meta-analysed data from studies of adult patients with chronic kidney failure undergoing hemodiaylsis who had taken part in a program of intradialytic exercise compared to a control group of patients that did not receive intradialytic exercise. The study reviewed type and duration of exercise, execution time, and frequency of intradialytic exercise and included randomized controlled trials (RCT) and quasi-experimental studies.One of the included studies within the review and meta-analysis was by Wilkinson et al.² This study does not meet the inclusion criteria for the review as this was an RCT of 36 patients with chronic kidney disease not requiring renal replacement therapy and the exercise program was not intra-dialytic exercise. Whilst there were 14 other studies included within these meta-analyses, there are profound differences between patients receiving hemodialysis and patients not requiring renal replacement therapy and in the exercise interventions. Given the potential impact on the findings of the review, I am requesting that the authors re-analyse the results of the meta-analysis with the study by Wilkinson et al.² removed.