Figueiredo 2018.

Study characteristics
Methods	Study design Parallel RCT Study dates Duration of follow‐up: 16 weeks Time frame: January 2015 to December 2015
Participants	Study characteristics Setting: not reported Country: Brazil Inclusion criteria: > 18 years; not receiving anti‐inflammatory or antiallergic medication; under HD treatment 3 times/week for at least 3 months, and with arteriovenous fistula for HD access Exclusion criteria: any contraindication to physical exercise or inability to perform the functional tests Baseline characteristics Number (analysed/randomised): intervention group 1 (10/11); intervention group 2 (10/13); intervention group 3 (11/13) Mean age (years) (SD not reported): intervention group 1 (52.8); intervention group 2 (49.5); intervention group 3 (45.2) Sex (M/F): intervention group 1 (7/4); intervention group 2 (10/3); intervention group 3 (9/4) Dialysis type: HD Mean dialysis vintage (years) (SD not reported): intervention group 1 (4.4); intervention group 2 (3.0); intervention group 3 (4.9) Comorbidities CVD: not reported Diabetes: intervention group 1 (2/11); intervention group 2 (2/13); intervention group 3 (3/13) Hypertension: not reported Depression (clinician diagnosis): not reported
Interventions	Intervention classification Non‐pharmacological intervention Indication: study targeting fatigue Intervention group 1 Inspiratory muscle training at 50% of MIP for 8 weeks Intervention group 2 Aerobic training low intensity for 8 weeks Intervention group 3 Combined training (inspiratory muscle training + aerobic training) for 8 weeks Co‐interventions The dialysis prescription and medication therapy remained unchanged during the study
Outcomes	Outcomes reported Fatigue outcome measures used: validation data available Functional capacity (incremental shuttle walk test): assessed at baseline, weeks 8 and 16 MIP and lower limbs strength (sit‐to‐stand test of 30 seconds): assessed at baseline, weeks 8 and 16 Plasma levels of IL‐6, soluble tumour necrosis factor receptor 1 and 2, adiponectin, resistin and leptin, redox status parameters: assessed at baseline, weeks 8 and 16 Anthropometric/physical parameters (weight, BMI, waist circumference and body fat percentage): assessed at baseline, weeks 8 and 16 QoL KDQOL‐SF: assessed at baseline, weeks 8 and 16
Notes	Funding: FundacËão de Amparo à Pesquisa do Estado de Minas Gerais, APQ‐03093‐15; Conflicts of interest/disclosures: none Trial registration identification number: Registro Brasileiro de Ensaios clõÂnicos RBR‐4hv9rs A priori published protocol was reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Sequence generation methods were not reported in sufficient detail to permit judgement.
Allocation concealment (selection bias)	Low risk	Quote: "Randomisation was performed using individual allocation codes placed within opaque, sealed envelopes by a person having no contact with the participants."
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not reported. However, interventions were different and participants and/or investigators could be aware of the treatment assigned.
Blinding of outcome assessment (detection bias) All outcomes	High risk	Fatigue was assessed with an appropriate measure, without differences between groups. However, subjective measures were used, it was not stated whether outcomes were assessed without knowledge of treatment allocation, and knowledge of treatment assignment may have influenced reporting. Participant/investigators beliefs about the superiority/inferiority of either intervention could have influenced their assessment of the outcome, but there was no evidence that this was likely. It was not stated if the monitoring group was blinded to the treatment assigned. However, objective and subjective outcomes were assessed.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Quote: "Intention‐to‐treat." Comment: 10/11 participants in the intervention group 1 (IMT), 10/13 participants in the intervention group 2 (at), and 11/13 participants in the intervention group3 3 (combination) completed the study. However ITT was performed.
Selective reporting (reporting bias)	Low risk	Information about the protocol and the statistical analysis plan were reported. Fatigue was reported using multiple eligible outcome measurements (scales, time points). Fatigue was reported in a format that was not extractable for meta‐analysis. All outcomes that should be addressed (fatigue, cardiovascular disease, and death) were reported, but fatigue was not extractable.
Other bias	Low risk	There was no evidence of different baseline characteristics, or different non‐randomised co‐interventions between groups. Funding was unlikely to influence the data analysis and authors had conflicts of interests. No other source of bias were apparent.