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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

Kidney transplantation: a systematic review of interventional and observational studies of physical activity on intermediate outcomes

Review published: 2009.

Bibliographic details: Macdonald JH, Kirkman D, Jibani M.  Kidney transplantation: a systematic review of interventional and observational studies of physical activity on intermediate outcomes. Advances in Chronic Kidney Disease 2009; 16(6): 482-500. [PubMed: 19801137]

Quality assessment

This review concluded that some types of exercise improved physical functioning, muscle strength, aerobic fitness and/or quality of life in kidney transplant patients. The authors acknowledged that some interventions were poor quality and the included studies were potentially biased and underpowered. Given the paucity of good-quality evidence and the potential for missed studies, the conclusions should be interpreted with caution. Full critical summary


Kidney transplant patients have decreased quality and longevity of life. Whether exercise can positively affect associated outcomes such as physical functioning, metabolic syndrome, kidney function, and immune function, has only been addressed in relatively small studies. Thus the aim of this systematic review was to determine effects of physical activity level on these intermediate outcomes in kidney transplant patients. We electronically and hand searched to identify 21 studies (6 retrospective assessments of habitual physical activity and 15 intervention studies including 6 controlled trials). After study quality assessment, intermediate outcomes associated with quality and longevity of life were expressed as correlations or percentage changes in addition to effect sizes. Habitual physical activity level was positively associated with quality of life and aerobic fitness and negatively associated with body fat (medium to large effect sizes). Exercise interventions also showed medium to large positive effects on aerobic capacity (10%-114% increase) and muscle strength (10%-22% increase). However, exercise programs had minimal or contradictory effects on metabolic syndrome and immune and kidney function. In kidney transplant patients, physical activity intervention is warranted to enhance physical functioning. Whether exercise impacts on outcomes associated with longevity of life requires further study.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2013 University of York.

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