The effects of exercise on VO2 peak, strength, body mass index and quality of life in kidney transplant recipients.

Abstract

Kidney transplant recipients are at an increased risk of death from a cardiovascular event. Loss of graft function is most commonly caused by a cardiovascular event that leads to death. Exercise is known to reduce the risk of cardiovascular disease in other chronic disease populations. Previous systematic reviews on the effects of exercise with kidney transplant recipients on cardiovascular risk have reported a small number of studies of a low quality. This systematic review aimed to investigate the effects of exercise interventions on cardiovascular risk of kidney transplant recipients. As direct measures of mortality were not available, suitable outcomes of VO2 peak, strength, body mass index and quality of life were used. Literature was collected by searching of Databases including PubMed, Cochrane Library, MEDLINE, SportsDiscus and Scopus. Studies that conducted an exercise intervention using adult, kidney transplant recipients within randomised controlled trials and controlled trials that reported effects on VO2 peak, strength, BMI and quality of life were included. In total 13 studies were included. Results were of mixed quality with none achieving maximum scores when assessed with the PEDro quality assessment scale. Studies were characterised by small sample sizes and short-term follow ups. Details of exercise programmes and results were not well reported. Exercise interventions were varied with different frequency, intensity, setting and modalities. Results show that an improvement in VO2 peak, strength and quality of life is common following exercise interventions in this population. The current literature shows mixed effects on body mass index with exercise interventions unlikely to cause significant improvement. Exercise is safe for kidney transplant patients however evidence does not exist for the direct effect of exercise on reduction of cardiovascular risk. Future studies should include larger samples conducted over more than 12 months with an extended follow up. Strategies to support adherence and reduce dropout should also be investigated in future studies. Studies of direct outcomes of the effect of exercise on cardiovascular risk, for example mortality, would improve upon current evidence.