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Systematic Review

Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis

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Therapies Department, King’s College Hospital NHS Trust, London SE5 9RS, UK
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King’s Kidney Care, King’s College Hospital, London SE5 9RS, UK
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Renal Sciences, King’s College London, London SE5 9RS, UK
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Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK
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Victor Horsley Department of Neurosurgery, University College London Hospital, London WC1N 3BG, UK
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Department of Women and Children’s Health, Faculty of Life Sciences and Medicine, King’s College London, London SE5 9RS, UK
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Department of Health Psychology, King’s College London, London SE1 9RT, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Giorgina Barbara Piccoli
Kidney Dial. 2021, 1(2), 100-120; https://doi.org/10.3390/kidneydial1020014
Received: 9 August 2021 / Revised: 13 September 2021 / Accepted: 14 September 2021 / Published: 2 October 2021
(This article belongs to the Special Issue Lifestyle Interventions to Prevent Kidney Diseases)
Weight gain within the first year of kidney transplantation is associated with adverse outcomes. This narrative systematic review and meta-analysis examines the effect of exercise, physical activity, dietary, and/or combined interventions on body weight and body mass index (BMI) within the first year of kidney transplantation. Seven databases were searched from January 1985 to April 2021 (Prospero ID: CRD42019140865), using a ‘Population, Intervention, Controls, Outcome’ (PICO) framework. The risk-of-bias was assessed by two reviewers. A random-effects meta-analysis was conducted on randomized controlled trials (RCTs) that included post-intervention body weight or BMI values. Of the 1197 articles screened, sixteen met the search criteria. Ten were RCTs, and six were quasi-experimental studies, including a total of 1821 new kidney transplant recipients. The sample sizes ranged from 8 to 452. Interventions (duration and type) were variable. Random-effects meta-analysis revealed no significant difference in post-intervention body weight (−2.5 kg, 95% CI −5.22 to 0.22) or BMI (−0.4 kg/m2, 95% CI −1.33 to 0.54). Despite methodological variance, statistical heterogeneity was not significant. Sensitivity analysis suggests combined interventions warrant further investigation. Five RCTs were classified as ‘high-risk’, one as ‘some-concerns’, and four as ‘low-risk’ for bias. We did not find evidence that dietary, exercise, or combined interventions led to significant changes in body weight or BMI post kidney transplantation. The number and quality of intervention studies are low. Higher quality RCTs are needed to evaluate the immediate and longer-term effects of combined interventions on body weight in new kidney transplant recipients. View Full-Text
Keywords: kidney transplant; weight gain; body weight; systematic review; physical activity; meta-analysis kidney transplant; weight gain; body weight; systematic review; physical activity; meta-analysis
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MDPI and ACS Style

Castle, E.M.; McBride, E.; Greenwood, J.; Bramham, K.; Chilcot, J.; Greenwood, S.A. Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis. Kidney Dial. 2021, 1, 100-120. https://doi.org/10.3390/kidneydial1020014

AMA Style

Castle EM, McBride E, Greenwood J, Bramham K, Chilcot J, Greenwood SA. Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis. Kidney and Dialysis. 2021; 1(2):100-120. https://doi.org/10.3390/kidneydial1020014

Chicago/Turabian Style

Castle, Ellen M., Emily McBride, James Greenwood, Kate Bramham, Joseph Chilcot, and Sharlene A. Greenwood 2021. "Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis" Kidney and Dialysis 1, no. 2: 100-120. https://doi.org/10.3390/kidneydial1020014

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