Skeletal muscle limits the exercise tolerance of renal transplant recipients: effects of a graded exercise training program.

Sixteen renal transplant recipients were studied before and after they had participated in a 24-week exercise training program to determine (1) the nature of the factors explaining their impaired exercise tolerance, and (2) their adaptative responses to exercise training. During progressive treadmill exercise to exhaustion prior to training, renal transplant recipients stopped exercising at lower peak rates of oxygen consumption (VO2max) (29.0 +/- 7.8 47.9 +/- 9.1 mL O2.kg-1.min-1; P less than 0.001) and ventilation (55.9 +/- 13.2 v 124.0 +/- 22.2 L.min-1; P less than 0.0001), and at lower peak heart rates (169 +/- 22 v 196 +/- 9 beats.min-1; P less than 0.05) and peak blood lactate concentrations (5.0 +/- 2.1 v 11.5 +/- 4.0 mmol.L-1; P less than 0.001) than did controls. None showed a plateau in oxygen consumption with increasing workload. Exercise time to exhaustion was also significantly shorter in renal transplant recipients (9.5 +/- 1.8 v 16.0 +/- 1.3 min; P less than 0.0001). After training, exercise time to exhaustion (12.0 +/- 2.0 min; P less than 0.001), VO2max (37.5 +/- 4.8 mL O2.kg-1.min-1; P less than 0.05), maximum ventilation rate (68.5 +/- 14.0 L.min-1; P less than 0.05), peak blood lactate concentrations (7.8 +/- 1.8 mmol-L-1; P less than 0.001), and the rate of oxygen consumption at a blood lactate concentration of 2.0 mmol.L-1 (22.5 +/- 2.5 v 16.5 +/- 2.2 mL O2.kg-1.min-1; P less than 0.001) had all increased significantly.(ABSTRACT TRUNCATED AT 250 WORDS)