Oguchi Hideyo, Tsujita Makoto, Yazawa Masahiko, Kawaguchi Takehiko, Hoshino Junichi, Kohzuki Masahiro, Ito Osamu, Yamagata Kunihiro, Shibagaki Yugo, Sofue Tadashi
Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan.
Department of Kidney Disease Center, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Clin Exp Nephrol. 2019 Feb;23(2):275-284. doi: 10.1007/s10157-018-1633-8. Epub 2018 Aug 24.
The effectiveness of exercise in kidney transplant recipients is not well established. We, therefore, performed a systematic review of the effects of exercise training in kidney transplantation recipients.
We searched two electronic databases for articles up to April 2017. Inclusion criteria were as follows: randomized controlled trial and kidney transplant recipients aged 18 years or older. The main outcomes were allograft function (estimated glomerular filtration rate, eGFR), exercise tolerance (VO peak), and quality of life (QOL).
After screening of 1303 references in PubMed and Ichushi, six randomized control trials were analyzed. For kidney transplant recipients, supervised exercise training was shown to significantly improve VO peak [mean difference 2.42; 95% confidence interval (95%CI) 0.22-4.63] and QOL (mean difference 7.23; 95%CI 0.94-13.52). However, exercise training did not improve allograft kidney function (mean difference 6.22; 95%CI - 13.00 to 25.44). No reporting bias was observed in any of the outcomes. There were no reports including patient survival rates and the harm associated with exercise training.
Exercise training for kidney transplant recipients significantly improved exercise tolerability and QOL, but a significant improvement was not obtained with respect to allograft kidney function. Evaluation of patient survival rates and the harm associated with exercise training has not been reported, therefore, future studies are needed to resolve these issues.
运动对肾移植受者的有效性尚未得到充分证实。因此，我们对运动训练对肾移植受者的影响进行了系统评价。
我们检索了两个电子数据库，查找截至2017年4月的文章。纳入标准如下：随机对照试验，以及年龄在18岁及以上的肾移植受者。主要结局指标为移植肾功能（估计肾小球滤过率，eGFR）、运动耐量（峰值摄氧量）和生活质量（QOL）。
在对PubMed和Ichushi中的1303篇参考文献进行筛选后，分析了6项随机对照试验。对于肾移植受者，有监督的运动训练显示可显著改善峰值摄氧量[平均差值2.42；95%置信区间（95%CI）0.22 - 4.63]和生活质量（平均差值7.23；95%CI 0.94 - 13.52）。然而，运动训练并未改善移植肾功能（平均差值6.22；95%CI - 13.00至25.44）。在任何结局指标中均未观察到报告偏倚。没有关于患者生存率和运动训练相关危害的报道。
肾移植受者的运动训练显著改善了运动耐量和生活质量，但移植肾功能未得到显著改善。尚未有关于患者生存率和运动训练相关危害的评估报告，因此，需要未来的研究来解决这些问题。
