EFFECT OF PHYSICAL EXERCISE ON IRISIN SECRETION IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND ITS NEUROLOGICAL EFFECTS: A SYSTEMATIC REVIEW

Abstract

Chronic Kidney Disease (CKD) and its associated neurological complications are growing global concerns, making physical exercise (PE) a vital non-pharmacological intervention, with irisin emerging as a potential mediator of its benefits. This systematic review aimed to analyze PE's influence on irisin levels in CKD patients and its relation to neurological changes. A search in PubMed, Web of Science, Scopus, and Cochrane Library (March 2025; 2015-2025) used descriptors such as "Irisin AND Chronic Kidney Disease AND Physical Exercise AND Neurologic Disease." From 26 identified articles, only three English-language studies met eligibility, and their methodological quality was assessed via the Delphi Checklist. The included studies examined irisin-physical capacity correlation in hemodialysis, the effect of 12 weeks of resistance training on irisin, and acute resistance exercise effects. Crucially, no study directly linked irisin to neurological dysfunctions in CKD, nor investigated aerobic exercise. Findings suggest chronic resistance training can elevate irisin levels, contributing to functional and metabolic improvements, potentially via AMPK pathway activation. Irisin, known for crossing the blood-brain barrier and its neuroprotective properties in animal models, may modulate neuroinflammation. Nevertheless, the scarcity of research, particularly on aerobic exercise, irisin, and neurological complications, limits broader conclusions. Methodological weaknesses (e.g., lack of randomization, blinding) in the reviewed studies emphasize the urgent need for robust randomized controlled trials and longitudinal studies. Future investigations should focus on clarifying aerobic exercise's effects and irisin's direct role in neurological health in CKD patients, aiming for innovative therapeutic strategies and sustained improvements in quality of life.