The efficacy of exercise training in kidney transplant recipients: a meta-analysis and systematic review
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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.
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).
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.
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.
KeywordsExercise training Kidney transplantation Peak VO2 Allograft function QOL
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.
Compliance with ethical standards
Conflict of interest
The authors have declared that no conflict of interest exists.
Human and animal rights
This article does not contain any studies with human participants performed by any of the authors.
Informed consent was obtained from all individual participants included in the study by each investigator.
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