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Background and aims: Evidences on the benefits of physical exercise in kidney transplant patients (KTx) are not conclusive
and concerns on safety remain. We here gather and interpret current evidence on the benefits/harms of exercise training
intervention in KTx.
Methods: Systematic review of exercise training programs in KTx.
Results: A total of 24 studies including 654 KTx patients on intervention and 536 controls were evaluated. The median age
was 46 years; the transplant vintage was 2 days to 10 years. The intervention was an aerobic or resistance exercise program
or a combination of both; interventions consisted of 20–60 min’ sessions, 2–3 times per week repetitions and 5.5 months’
median duration. Most studies improved cardiorespiratory fitness (expressed as VO2peak) as well as maximum heart rate,
which was associated with a significant increase in muscle performances and strength. No significant changes in body weight
or composition were observed, but a trend towards weight reduction in overweight or obese patients on stable KTx was noted.
The arterial blood pressure reduced a little after exercise when it was high at start. Exercise intervention had no clinically
relevant impact on anaemia, glycaemia or lipidaemia. In contrast, exercise training improved several aspects of quality of
life. No data on long-term hard outcomes or on high-risk subpopulations such comorbid or elderly patients were available.
Conclusions: In adult kidney transplant patients, a structured physical exercise program improved the aerobic capacity and
ameliorated muscle performance and quality of life. No harms were observed in the short-term, but long-term RCTs are
required. Overall, in mid-age kidney transplant patients without major comorbidities, an aerobic or resistance supervised
exercise lasting 3–6 months could be suggested within the comprehensive treatment of kidney transplant.
Journal of Nephrology (2019) 32:567–579
Patrizia Calella, Sonsoles Hernández‑Sánchez, Carlo Garofalo, Jonatan R. Ruiz. Juan J. Carrero, Vincenzo Bellizzi
