Clinical and Experimental Nephrology

, Volume 23, Issue 2, pp 275–284 | Cite as

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

  • Hideyo Oguchi
  • Makoto Tsujita
  • Masahiko Yazawa
  • Takehiko Kawaguchi
  • Junichi Hoshino
  • Masahiro Kohzuki
  • Osamu Ito
  • Kunihiro Yamagata
  • Yugo Shibagaki
  • Tadashi SofueEmail author
Original article



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.


Exercise 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 (, 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

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

Supplementary material

10157_2018_1633_MOESM1_ESM.docx (23 kb)
Supplementary material 1 (DOCX 22 KB)


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Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  • Hideyo Oguchi
    • 1
  • Makoto Tsujita
    • 2
  • Masahiko Yazawa
    • 3
  • Takehiko Kawaguchi
    • 4
  • Junichi Hoshino
    • 5
  • Masahiro Kohzuki
    • 6
  • Osamu Ito
    • 7
  • Kunihiro Yamagata
    • 8
  • Yugo Shibagaki
    • 3
  • Tadashi Sofue
    • 9
    Email author
  1. 1.Department of Nephrology, Faculty of MedicineToho UniversityTokyoJapan
  2. 2.Department of Kidney Disease CenterNagoya Daini Red Cross HospitalNagoyaJapan
  3. 3.Department of Nephrology and HypertensionSt. Marianna University School of MedicineKawasakiJapan
  4. 4.Department of NephrologyNational Hospital Organization Chiba-East HospitalChibaJapan
  5. 5.Nephrology Center, Toranomon HospitalTokyoJapan
  6. 6.Department of Internal Medicine and Rehabilitation ScienceTohoku University Graduate School of MedicineSendaiJapan
  7. 7.Division of General Medicine and Rehabilitation, Faculty of MedicineTohoku Medical and Pharmaceutical UniversitySendaiJapan
  8. 8.Department of Nephrology, Faculty of MedicineUniversity of TsukubaIbarakiJapan
  9. 9.Division of Nephrology and Dialysis, Department of Cardiorenal and Cerebrovascular MedicineKagawa UniversityKagawaJapan

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