Exercise training improves aerobic capacity, muscle strength, and quality of life in renal transplant recipients

Abstract

Renal transplant recipients (RTR) have reduced peak aerobic capacity, muscle strength, arterial function and an unfavorable cardiovascular disease risk (CVD) profile. This study compared the effects of 12 weeks of supervised endurance and strength training (EST, n = 16) versus usual care (UC, n = 15) on peak aerobic capicity, cardiovascular and skeletal muscle function, CVD risk profile, and quality of life (QOL) in RTR (55 ± 13 years). Peak aerobic capacity and exercise hemodynamics, arterial compliance, 24-h blood pressure, muscle strength, lean body mass, CVD risk score, and QOL were assessed before and after 12 weeks. The change in peak aerobic capacity (EST: 2.6 ± 3.1 vs. UC: -0.5 ± 2.5 mL/(kg·min)), cardiac output (EST: 1.7 ± 2.6 vs. UC: -0.01 ± 0.8 L/min), leg press (EST: 48.7 ± 34.1 vs. UC: -10.5 ± 37.7 kg) and leg extension strength (EST: 9.5 ± 10.3 vs. UC: 0.65 ± 5.5 kg) improved significantly after EST compared with UC. The overall change in QOL improved significantly after 12 weeks of EST compared with UC. No significant difference was found between groups for lean body mass, arterial compliance, 24-h blood pressure or CVD risk score. Supervised EST is an effective intervention to improve peak exercise aerobic capacity and cardiac output, muscle strength and QOL in clinically stable RTR.

Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients

“…There is mounting evidence that physical exercise reduces the risk of all-cause mortality[ 2 , 3 ] and it is effective in the primary and secondary prevention of CVD in the general population[ 4 ]. Physical activity is also considered a key element in the prevention and management of chronic diseases[ 5 ], including Chronic Kidney Disease (CKD).…”

“…Whether exercise can positively affect outcomes in KTRs has only been addressed in few studies[ 4 ], with a small number of subjects and with different types, intensity and durations of interventions lasting almost always not more than six months[ 10 , 11 ]. In some studies, exercise was carried out tightly at home without direct supervision and with a partial adherence to the intervention[ 6 ].…”

Cardiovascular Outcomes in Renal Transplant Recipients: Feasibility and Clinical Role of 2D Speckle Tracking to Assess Myocardial Function

“…Renal transplantation is a very common procedure in terminal kidney disease [6,21]. Patients do not often quickly resume a normal active lifestyle after surgery.…”

“…Sedentary behavior and reduced daily physical activity represent the basic underlying causes for progressive worsening of those cardiovascular risk factors related to limited survivorship and increased morbidity [22]. It has been widely demonstrated that physical training improves particularly those cardiovascular risk factors strongly associated with a high risk of disability and death [1,21], especially if performed at moderate intensities [6,21]. Proper exercise can be however a complicated context considering the presence of many cardiovascular risks factors often present in an associated form as in the case of post-transplant syndrome.…”

Short-term prospective study of prescribed physical activity in kidney transplant recipients

“…Kidney transplantation is the best treatment for end stage renal disease, and it allows better patient survival compared to staying on dialysis [16,17]. Patients do not often quickly resume a normal active lifestyle after surgery, and they also have a cardiovascular mortality rate that is much greater than in the general population.…”