ホシノ　ジュンイチ   Hoshino Junichi   星野　純一    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Efficacy of Neuromuscular Electrical Stimulation in Patients on Hemodialysis: An Updated Systematic Review and Meta-analysis.
掲載誌名	正式名：Kidney medicine 略　 称：Kidney Med ISSNコード：25900595/25900595
掲載区分	国外
巻・号・頁	8(6),pp.101368
著者・共著者	Otobe Yuhei, Usui Naoto, Kojima Sho, Shirai Nobuyuki, Suzuki Yuta, Kono Kenichi, Yabe Hiroki, Matsufuji Shota, Sofue Tadashi, Fujii Naohiko, Narita Ichiei, Yamagata Kunihiro, Hoshino Junichi, Matsuzawa Ryota, Saitoh Masakazu
発行年月	2026/06
概要	RATIONALE & OBJECTIVE:Kidney disease is associated with reduced physical function, muscle mass, and quality of life (QoL). Neuromuscular electrical stimulation (NMES) is a promising intervention to address these outcomes. This study aimed to update previous meta-analyses by including the latest randomized controlled trials (RCTs).STUDY DESIGN:Systematic review and meta-analysis of RCTs.SETTING & STUDY POPULATIONS:RCTs evaluating effects of NMES in adult patients with kidney disease.SELECTION CRITERIA FOR STUDIES:Outcomes included muscle strength, muscle mass, functional capacity, physical performance, activities of daily living, physical activity, health-related QoL, and adverse events.DATA EXTRACTION:A systematic search was conducted in PubMed, Cochrane Library, and ICHUSHI (April 27, 2024).ANALYTICAL APPROACH:Random-effects meta-analyses were performed using Review Manager 5.4. Risk of bias and certainty of evidence were assessed using RoB 2.0 and GRADE.RESULTS:Twelve RCTs involving 289 participants were included. All participants underwent hemodialysis; no studies included patients on peritoneal dialysis, with predialysis chronic kidney disease, or post-kidney transplant recipients. NMES significantly improved lower-limb muscle strength (standardized mean difference, 0.84; 95% CI, 0.56-1.11; P < 0.001), 6-minute walk distance (mean difference, 48.15; 95% CI, 15.86-80.44; P = 0.003), and sit-to-stand performance (standardized mean difference, 0.80; 95% CI, 0.17-1.43; P = 0.01), without significantly increasing adverse events. No significant effects were found on appendicular skeletal muscle mass, timed up and go test, Short Physical Performance Battery, activities of daily living, physical activity, or HRQoL. The certainty of evidence ranged from very low to moderate across outcomes.LIMITATIONS:Most studies had small sample sizes and high risk of bias.CONCLUSIONS:NMES is a safe and effective intradialytic intervention for improving lower-limb muscle strength and functional capacity in patients undergoing hemodialysis. High-quality RCTs involving broader kidney disease populations are warranted to further establish its clinical utility.
DOI	10.1016/j.xkme.2026.101368
PMID	42222442