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The efficacy of exercise training in kidney transplant recipients: a meta-analysis and systematic review

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Abstract

Background

The effectiveness of exercise in kidney transplant recipients is not well established. We, therefore, performed a systematic review of the effects of exercise training in kidney transplantation recipients.

Methods

We searched two electronic databases for articles up to April 2017. Inclusion criteria were as follows: randomized controlled trial and kidney transplant recipients aged 18 years or older. The main outcomes were allograft function (estimated glomerular filtration rate, eGFR), exercise tolerance (VO2 peak), and quality of life (QOL).

Results

After screening of 1303 references in PubMed and Ichushi, six randomized control trials were analyzed. For kidney transplant recipients, supervised exercise training was shown to significantly improve VO2 peak [mean difference 2.42; 95% confidence interval (95%CI) 0.22–4.63] and QOL (mean difference 7.23; 95%CI 0.94–13.52). However, exercise training did not improve allograft kidney function (mean difference 6.22; 95%CI − 13.00 to 25.44). No reporting bias was observed in any of the outcomes. There were no reports including patient survival rates and the harm associated with exercise training.

Conclusions

Exercise training for kidney transplant recipients significantly improved exercise tolerability and QOL, but a significant improvement was not obtained with respect to allograft kidney function. Evaluation of patient survival rates and the harm associated with exercise training has not been reported, therefore, future studies are needed to resolve these issues.

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Acknowledgements

We are grateful to Dr. Yuki Kataoka, Hospital Care Research Unit/Department of Respiratory Medicine Hyogo Prefectural Amagasaki General Medical Center, for helpful comments on the statistical analysis in our systematic review. This systematic review was performed for the guidelines of the Japanese Society of Renal Rehabilitation on behalf of the guideline committee of the Japanese Society of Renal Rehabilitation. We thank Simon Teteris, PhD, from the Edanz Group (http://www.edanzediting.com/ac), for editing the English text of a draft of this manuscript.

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Author notes

  1. Hideyo Oguchi and Makoto Tsujita equally contributed to the article.

Authors and Affiliations

  1. Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan

    Hideyo Oguchi

  2. Department of Kidney Disease Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Makoto Tsujita

  3. Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kawasaki, Japan

    Masahiko Yazawa & Yugo Shibagaki

  4. Department of Nephrology, National Hospital Organization Chiba-East Hospital, Chiba, Japan

    Takehiko Kawaguchi

  5. Nephrology Center, Toranomon Hospital, Tokyo, Japan

    Junichi Hoshino

  6. Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan

    Masahiro Kohzuki

  7. Division of General Medicine and Rehabilitation, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan

    Osamu Ito

  8. Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan

    Kunihiro Yamagata

  9. Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University, 1750-1 Ikenobe, Miki-Chou, Kida-Gun, Kagawa, 761-0793, Japan

    Tadashi Sofue

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  1. Hideyo Oguchi
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Correspondence to Tadashi Sofue.

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This article does not contain any studies with human participants performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study by each investigator.

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Oguchi, H., Tsujita, M., Yazawa, M. et al. The efficacy of exercise training in kidney transplant recipients: a meta-analysis and systematic review. Clin Exp Nephrol 23, 275–284 (2019). https://doi.org/10.1007/s10157-018-1633-8

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  • DOI: https://doi.org/10.1007/s10157-018-1633-8

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