Height‐adjusted lean body mass and its associations with physical activity and kidney function in pediatric kidney transplantation

Ahmed, Azim; Coté, Anita T.; Lui, Samantha; Blydt-Hansen, Tom

doi:10.1111/petr.14128

Cited by 3 publications

(3 citation statements)

References 116 publications

(182 reference statements)

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“…In the general adolescent population, physical activity and its associated osteogenic effects have been shown to modify bone strength and quality during this particular period in various studies using DXA and HR-pQCT [44][45][46]. However, compared with the general population, physical activity levels are lower in pediatric kidney recipients and do not always improve after transplantation [47][48]. We show here that TEE tended to improve 6 months post-transplant and that TEE 6 months post Tx correlated with lean body mass and cortical bone parameters.…”

Section: Discussionmentioning

confidence: 99%

Changes in High Resolution peripheral Quantitative Computed Tomography in adolescents undergoing a first kidney transplantation.

De Mul,

Leclerc,

Ginhoux

et al. 2024

Preprint

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Purpose Mineral bone disorders associated to chronic kidney disease (CKD-MBD) frequently persist after kidney transplantation (Tx), being due to pre-existing CKD-MBD, immunosuppressive therapies and post-Tx hypophosphatemia. We aimed to evaluate bone biomarkers and microarchitecture at the time of and 6 months after Tx. Methods Here we present the single-center sub-group of patients included between 10 and 18 years of age from the prospective TRANSOS study (NCT02729142). Patients undergoing a first Tx were matched on a 1:2 basis on sex, puberty and age with healthy controls (HC) from the VITADOS cohort. Results are presented as median (Q1-Q3). Non-parametric tests were performed. Results At a median age of 15 (13-16) years, 19 patients (6 girls, 7 pre-emptive Tx, 7 steroid-sparing immunosuppressive strategies) underwent a first Tx, with PTH levels of 1.9 (1.4-2.9) the upper limit of normal (ULN). When comparing HC and patients at the time of Tx, we found significantly higher total and trabecular densities with High Resolution peripheral Quantitative Computed Tomography (HR-pQCT). Six months after Tx, patients displayed significantly impaired trabecular parameters at radius compared to baseline; results were not different at the weight-bearing tibia, neither cortical parameters at both sites. Six months after Tx, 6 (31%) patients displayed acidosis, 10 (53%) persistent hyperparathyroidism (always < 2 ULN) and 5 (26%) increased FGF23 levels; 11 (58%) received phosphate supplementation. Conclusion Data on bone health in adolescent receiving a first Tx seem reassuring, but radial trabecular bone microarchitecture impairment observed 6 months post-Tx may reflect subtle albeit present post-Tx CKD-MBD. NCT02729142- March 25 2016

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Section: Discussionmentioning

confidence: 99%

Changes in High Resolution peripheral Quantitative Computed Tomography in adolescents undergoing a first kidney transplantation.

De Mul,

Leclerc,

Ginhoux

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…In the general adolescent population, physical activity and its associated osteogenic effects have been shown to modify bone strength and quality during this particular period in various studies using DXA and HR-pQCT [44][45][46]. However, compared with the general population, physical activity levels are lower in pediatric kidney recipients and do not always improve after transplantation [47][48]. We show here that TEE tended to improve 6 months post-transplant and that TEE 6 months post R-Tx correlated with lean body mass and cortical bone parameters.…”

Section: Discussionmentioning

confidence: 99%

Changes in High Resolution peripheral Quantitative Computed Tomography (HR-pQCT) in teenagers undergoing a first renal transplantation between baseline and 6 months

de Mul,

Leclerc,

Ginhoux

et al. 2023

Preprint

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Background Mineral bone disorders associated to chronic kidney disease (CKD-MBD) frequently persist after renal transplantation (R-Tx), being due to pre-existing CKD-MBD, immunosuppressive therapies and post-Tx hypophosphatemia. We aimed to evaluate bone biomarkers and microarchitecture at the time of and 6 months after R-Tx. Methods Here we present the single-center sub-group of patients included between 10 and 18 years of age from the prospective TRANSOS study (NCT02729142). Patients undergoing a first R-Tx were matched on a 1:2 basis on gender, puberty and age with healthy controls (HC) from the VITADOS cohort. Results are presented as median (Q1-Q3). Non-parametric tests were performed. Results At a median age of 15 (13-16) years, 19 patients (6 girls, 7 pre-emptive R-Tx, 7 steroid-sparing immunosuppressive strategies) underwent a first R-Tx, with PTH levels of 1.9 (1.4-2.9) the upper limit of normal (ULN). When comparing HC and patients at the time of R-Tx, bone parameters assessed with High Resolution peripheral Quantitative Computed Tomography (HR-pQCT) were significantly better in patients. Six months after R-Tx, patients displayed significantly impaired trabecular parameters at radius compared to baseline; results were not different at the weight-bearing tibia, neither cortical parameters at both sides. Six months after R-Tx, 6 (31%) patients displayed acidosis, 10 (53%) persistent hyperparathyroidism (always < 2 ULN) and 5 (26%) increased FGF23 levels; 11 (58%) received phosphate supplementation. Conclusion Data on bone health in teenagers receiving a first R-Tx seem reassuring, but radial trabecular bone microarchitecture impairment observed 6 months post-Tx may reflect subtle albeit present post-Tx CKD-MBD.

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“…In addition, exercise in SOT can potentially mitigate secondary transplant-related conditions including cardiovascular risk factors, fatigue, osteoporosis, and muscle atrophy, and promote return to work and societal roles (3,4). However, the post-transplant effects of extended hospital length of stay, prolonged physical inactivity, and immunosuppression are known to have significant adverse effects on exercise tolerance, skeletal muscle dysfunction, and cardiometabolic risk factors (3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Online resources as a source of information for exercise and physical activity in solid organ transplant recipients

Da Silva,

Momen,

Al Kaabi

et al. 2024

Front. Sports Act. Living

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IntroductionExercise training post-transplant has been shown to improve physical function and quality of life in solid organ transplant (SOT) recipients. Online resources in the form of websites and videos are commonly used to provide education and instruction on exercise and physical activity in SOT; however, the content and quality of these online resources has not been evaluated.MethodsThe first 200 websites and videos identified on Google and YouTube using the English search term “exercise and physical activity in solid organ transplantation” were analyzed. Website and video content was evaluated based on 25 key components of exercise and physical activity in SOT as described in established exercise program recommendations. Website and video quality was determined using DISCERN, Global Quality Scale (GQS), and Patient Education Materials and Assessment Tool (PEMAT; threshold for which material is deemed understandable or actionable is >70%). Parametric and non-parametric tests were used to assess website and video characteristics, content, and quality metrics.ResultsForty-nine unique SOT websites (n = 15) and videos (n = 34) were identified, with the two most common categories being foundation/advocacy organizations and scientific resources. The average reading grade level of websites was 13 ± 3. Website and video content scores varied significantly (websites 11.3 ± 6.4; videos 8.4 ± 5.3). DISCERN total score and GQS score were low (median range for DISCERN 2.5–3.0; median for GQS 2.0 for both websites and videos, out of 5). PEMAT understandability and actionability scores were also low across websites and videos (mean range 57%–67% and 47%–65%, respectively). Foundation/advocacy websites had higher content and quality scores compared to scientific organizations and news/media articles.ConclusionsTo our knowledge, this is the first comprehensive assessment of online content and quality of website and video resources on physical activity and exercise in adult SOT recipients. There were a limited number of online English patient-directed resources related to physical activity in SOT, most of which only partly captured items outlined in consensus exercise program recommendations and were of low quality and understandability and actionability. This work provides important insight to the English-speaking transplant community on the current state of online exercise health information and provides future direction for resource development.

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Height‐adjusted lean body mass and its associations with physical activity and kidney function in pediatric kidney transplantation

Cited by 3 publications

References 116 publications

Changes in High Resolution peripheral Quantitative Computed Tomography in adolescents undergoing a first kidney transplantation.

Changes in High Resolution peripheral Quantitative Computed Tomography in adolescents undergoing a first kidney transplantation.

Changes in High Resolution peripheral Quantitative Computed Tomography (HR-pQCT) in teenagers undergoing a first renal transplantation between baseline and 6 months

Online resources as a source of information for exercise and physical activity in solid organ transplant recipients

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