Preoperative evaluation of pulmonary functions is necessary in renal transplantation candidates. Exercise capacity determined by peak oxygen uptake (peak VO2) is a predictor of perioperative mortality and survival. The aim of this study was to determine the factors associated with peak VO2 in renal transplantation candidates undergoing hemodialysis. Thirty chronic renal failure patients undergoing hemodialysis, waiting for renal transplantation (age, 40.2 ± 10.3 years; female/male, 14/16; dialysis vintage, 133.1 ± 63.3 months), were included in the study. None of the patients had signs or symptoms of active infection and inflammation. Each patient underwent pulmonary function and symptomlimited cardiopulmonary exercise tests. Despite the absence of clinically evident inflammation, to assess comorbidity and risk of atherosclerosis, a malnutrition inflammation score was performed for each patient by same physician. Demographic and laboratory parameters were obtained from hospital records. Peak VO2 was positively correlated with serum triglyceride level (r: +0.543, P = .07) and negatively correlated with serum ferritin level (r: -0.452, P = .03) and malnutrition inflammation score (r: -0.455, P = .029). In conclusion, peak VO2 is associated with markers of nutrition and malnutrition inflammation score. We suggest that chronic malnutrition and silent inflammation may be responsible for the preoperative decreased exercise capacity in renal transplantation candidates undergoing hemodialysis.