Key result
Low-intensity resistance training did not significantly change central systolic pressure or cardiac workload in kidney transplant recipients, whereas standard care resulted in a significant reduction of 9 mmHg in central systolic pressure.
Why the study?
Although resistance training may reduce aortic stiffness in kidney transplant recipients, its impact on central hemodynamics and pulsatile cardiac load remains uncertain.
Does 6 months of low-intensity resistance training reduce cardiac workload and aortic stiffness in kidney transplant recipients compared to standard care?
RCT (n=85)
2:1 allocation ratio
No
Does 6 months of low-intensity resistance training reduce cardiac workload and aortic stiffness in kidney transplant recipients compared to standard care?
Mean Difference: -9 (95% CI -15–-3)
Absolute Event Rate: 121% vs 114%
p-value: p=0.004
In kidney transplant recipients, 6 months of low-intensity resistance training did not reduce cardiac workload or central systolic pressure, whereas standard care alone was associated with reductions in these parameters.
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Low-intensity resistance training leaves cardiac workload unchanged in kidney transplant recipients; challenges prior vascular benefits and leaves optimal regimens open.
Background Hypertension remains a major concern in kidney transplant recipients, in part due to the detrimental effects of standard care immunosuppressive therapy. Although resistance training appears safe and may reduce aortic stiffness in kidney transplant recipients, it lacks consistent brachial anti-hypertensive effects, and its impact on central hemodynamics and pulsatile cardiac load remains uncertain. We tested whether 6 months of low-intensity resistance training reduces cardiac workload by lowering central systolic pressure (cSBP) and aortic stiffness at rest. Methods We analyzed 85 kidney transplant recipients (resistance training: n = 57; standard care: n = 28) from a randomized trial. The intervention group completed biweekly, 60 min, personalized low-intensity resistance sessions targeting the upper and lower body. Radial applanation tonometry with a generalized transfer function enabled central aortic waveform analysis. Cardiac workload was assessed via wasted pressure effort (Ew) and systolic pressure time integral (SPTI). Carotid-femoral pulse wave velocity (cfPWV) was used as a measure of aortic stiffness. Results At baseline, groups did not differ in cSBP ( p = 0.767), Ew ( p = 0.321), and SPTI ( p = 0.219). Group-by-time interactions were observed for cSBP ( p = 0.049), Ew ( p = 0.022), and SPTI ( p = 0.019). Low-intensity resistance training showed no significant changes, while standard care exhibited reductions in cSBP (mean difference (Δ)6-bas = − 9 mmHg, 95% CI: − 15 to − 3 mmHg, p = 0.004), Ew (Δ 6-bas = − 992 dyne s. cm −2 , 95% CI: − 1864 to − 121 dyne s. cm −2 , p = 0.026), and SPTI (Δ 6-bas = − 3302 mmHg × ms, 95% CI: − 5780 to -824 mmHg × ms, p = 0.010). cf-PWV was unchanged in both groups (time: p = 0.478). Conclusions Low-intensity resistance training did not affect central arterial load on the heart, supporting its safety in kidney transplant recipients, while standard care may confer a cardiac workload benefit.
Marôco et al. (2026) conducted an RCT in Kidney transplant recipients (n=85). Low-intensity resistance training vs. Standard care was evaluated on Central systolic pressure (cSBP) (MD -9 mmHg, 95% CI -15 to -3, p=0.004). Low-intensity resistance training did not significantly change central systolic pressure or cardiac workload in kidney transplant recipients, whereas standard care resulted in a significant reduction of 9 mmHg in central systolic pressure.
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