Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Feb 13;7(4):100980.
doi: 10.1016/j.xkme.2025.100980. eCollection 2025 Apr.

Interventions to Improve Life Participation in Kidney Transplant Recipients: A Systematic Review

Patrizia Natale  1   2 , Angela Ju  1 , Martin Howell  1   3   4 , Germaine Wong  1   3   5 , Armando Teixeira-Pinto  1   3 , Anastasia Hughes  1   3 , Chandana Guha  1   3 , Amanda Sluiter  1   3 , Nicole Scholes-Robertson  6 , Jonathan C Craig  6 , Michelle A Josephson  7 , Giovanni Strippoli  1   2 , Allison Jaure  1   3
Affiliations
Review

Interventions to Improve Life Participation in Kidney Transplant Recipients: A Systematic Review

Patrizia Natale et al. Kidney Med. .

Abstract

Rationale & objective: Life participation, defined as the ability to participate in meaningful activities of daily living, is a critically important outcome for kidney transplant recipients. We aimed to evaluate the effectiveness of any interventions on life participation in kidney transplant recipients.

Study design: A systematic review of randomized controlled studies.

Study populations: Adult kidney transplant recipients.

Search strategy & sources: MEDLINE, Embase, CENTRAL, PsycINFO and CINAHL were searched up to March 2023.

Data extraction: Two authors independently screened titles and abstracts, and extracted data from the included studies using standard data extraction forms.

Analytical approach: We used random-effects models with relative risk for dichotomous outcomes and mean difference for continuous outcomes with 95% confidence intervals (CIs). Confidence in the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results: From 14,162 reports, only 33 studies (4,857 participants) were included. The risk of bias was adjudicated as high or unclear for most domains. No studies reported the outcome of life participation specifically. Among 33 studies, mental, physical and social functioning were reported in 5 (15%), 5 (15%), and 11 (33%) studies, respectively.

Limitations: A wide range of interventions were included across the studies with a limited follow-up, and we were unable to pool the data and perform meta-analysis for outcomes that were reported in a single study only or in studies reporting no events.

Conclusions: The effects of prebiotics, erythropoietin-stimulating agents, immunosuppressive treatments, induction therapy of interleukin-2 receptor antagonist, exercise, nutrition, education, and surgical procedures on life participation-related outcomes were uncertain. Life participation was not reported as a specific outcome in trials in kidney transplant recipients with very limited evidence on interventions for life participation-related outcomes. Trial-based evidence for interventions to improve life participation, a critical outcome for kidney transplant recipients, is needed.

Keywords: Kidney transplantation; life participation; quality of life; randomized controlled study; systematic review.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Search results.
Figure 2
Figure 2
Risk of bias graph.
See this image and copyright information in PMC

References

    1. Eng M., Zhang J., Cambon A., Marvin M.R., Gleason J. Employment outcomes following successful renal transplantation. Clin Transplant. 2012;26(2):242–246. - PubMed
    1. Esposito P., Furini F., Rampino T., et al. Assessment of physical performance and quality of life in kidney-transplanted patients: a cross-sectional study. Clin Kidney J. 2017;10(1):124–130. - PMC - PubMed
    1. Pinter J., Hanson C.S., Craig J.C., et al. ‘I feel stronger and younger all the time’-perspectives of elderly kidney transplant recipients: thematic synthesis of qualitative research. Nephrol Dial Transplant. 2016;31(9):1531–1540. - PubMed
    1. Pinter J., Hanson C.S., Chapman J.R., et al. Perspectives of older kidney transplant recipients on kidney transplantation. Clin J Am Soc Nephrol. 2017;12(3):443–453. - PMC - PubMed
    1. Talas M., Bayraktar N. Kidney transplantation: determination of the problems encountered by Turkish patients and their knowledge and practices on healthy living. J Clin Nurs. 2004;13(5):580–588. - PubMed

LinkOut - more resources