Exercise training in kidney transplant recipients: a systematic review

Area of Science:

• Nephrology
• Transplantation
• Exercise Physiology

Background:

• Evidence on exercise benefits and safety in kidney transplant patients (KTx) is inconclusive.
• Concerns regarding the safety of exercise interventions in KTx persist.
• This review synthesizes current evidence on exercise training benefits and harms in KTx.

Purpose of the Study:

• To systematically review and interpret the evidence on the benefits and harms of exercise training interventions in kidney transplant patients.
• To assess the impact of exercise on cardiorespiratory fitness, muscle performance, body composition, and quality of life in KTx.
• To identify gaps in the current literature, particularly regarding long-term outcomes and high-risk populations.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) and observational studies evaluating exercise training programs in KTx patients.
• Included studies involved aerobic, resistance, or combined exercise interventions.
• Data synthesis focused on cardiorespiratory fitness (VO2peak), muscle strength, body composition, blood pressure, metabolic markers, quality of life, and adverse events.

Main Results:

• 24 studies with 654 KTx patients showed improvements in cardiorespiratory fitness (VO2peak) and muscle performance.
• Exercise training positively impacted quality of life, with a trend towards weight reduction in overweight/obese patients.
• No significant short-term adverse effects were observed; however, data on long-term outcomes and high-risk groups were limited.

Conclusions:

• Structured exercise programs enhance aerobic capacity, muscle function, and quality of life in adult KTx patients.
• Short-term exercise interventions appear safe, but long-term randomized controlled trials are necessary.
• Supervised aerobic or resistance exercise for 3-6 months can be recommended for stable KTx patients without major comorbidities.