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World J Transplant. 2018 Feb 24;8(1):13-22. doi: 10.5500/wjt.v8.i1.13.

Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients.

Author information

Department of Education and Research, Isokinetic Medical Group, Bologna 40123, Italy.
Department of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì 47121, Italy.
Department of Biomedical & Neuromotor Sciences, University of Bologna, Bologna 40121, Italy.
Department of Cardiovascular, Sports Medicine, Noale 30033, Italy.
Sports Medicine, ULSS Company 9, Treviso 31100, Italy.
Sports Medicine, Regional Hospital of Bologna, Bologna 40121, Italy.
Department of Nephrology and Dialysis, S. Orsola Hospital, Bologna 40121, Italy.
Sports Medicine Unit DIMED, Department of Medicine, University of Padua, Padua 35100, Italy.
Sports Medicine, Regional Hospital of Modena, Modena 41100, Italy.
Sports Medicine, Regional Hospital of Ravenna, Ravenna 48121, Italy.
Sports Medicine, Regional Hospital of Parma, Parma 43121, Italy.
Department of Experimental and Clinical Medicine, School of Sports Medicine, University of Florence, Sports Medicine Centre, Florence 50100, Italy.
Italian National Transplant Centre, Rome 00161, Italy.



To evaluate the effect of a 12-mo supervised aerobic and resistance training, on renal function and exercise capacity compared to usual care recommendations.


Ninety-nine kidney transplant recipients (KTRs) were assigned to interventional exercise (Group A; n = 52) and a usual care cohort (Group B; n = 47). Blood and urine chemistry, exercise capacity, muscular strength, anthropometric measures and health-related quality of life (HRQoL) were assessed at baseline, and after 6 and 12 mo. Group A underwent a supervised training three times per week for 12 mo. Group B received only general recommendations about home-based physical activities.


Eighty-five KTRs completed the study (Group A, n = 44; Group B, n = 41). After 12 mo, renal function remained stable in both groups. Group A significantly increased maximum workload (+13 W, P = 0.0003), V'O2 peak (+3.1 mL/kg per minute, P = 0.0099), muscular strength in plantar flexor (+12 kg, P = 0.0368), height in the countermovement jump (+1.9 cm, P = 0.0293) and decreased in Body Mass Index (-0.5 kg/m2, P = 0.0013). HRQoL significantly improved in physical function (P = 0.0019), physical-role limitations (P = 0.0321) and social functioning scales (P = 0.0346). No improvements were found in Group B.


Twelve-month of supervised aerobic and resistance training improves the physiological variables related to physical fitness and cardiovascular risks without consequences on renal function. Recommendations alone are not sufficient to induce changes in exercise capacity of KTRs. Our study is an example of collaborative working between transplant centres, sports medicine and exercise facilities.


Aerobic exercise; Kidney transplant recipients; Muscle strength; Renal function; Supervised exercise

Conflict of interest statement

Conflict-of-interest statement: Dr. Nanni Costa has nothing to disclose.

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