Impaired Arterial Compliance and Aerobic Endurance in Kidney Transplant Recipients

Riess, Kenneth; Gourishankar, Sita; Oreopoulos, Antigone; Jones, Lee W.; McGavock, Jon; Lewanczuk, Richard; Haykowsky, Mark J.

doi:10.1097/01.tp.0000233347.40682.21

Cited by 10 publications

(11 citation statements)

References 19 publications

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“…Our group has previously shown that RTR have reduced aerobic endurance and decreased small and large arterial compliance compared with age-matched healthy predicted values (Riess et al 2006). Regular endurance training improves peripheral arterial function in healthy humans and individuals at risk for or with CVD (Green et al 2011); however, the effect of exercise to attenuate or reverse the impaired arterial function in RTR is unknown.…”

Section: Exercise Training and Arterial Compliance And Cvd Riskmentioning

confidence: 97%

“…As previously described (Riess et al 2006), small and large arterial compliance was assessed using computerized arterial pulse waveform analysis (Hypertension Diagnostics, Eagan, Minn., USA). Arterial compliance was derived from the analysis of the diastolic waveform decay using the modified Windkessel model of circulation (McVeigh et al 1999).…”

Section: Small and Large Arterial Compliancementioning

confidence: 99%

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

Riess

Haykowsky

Lawrance

et al. 2014

Appl. Physiol. Nutr. Metab.

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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.

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Section: Exercise Training and Arterial Compliance And Cvd Riskmentioning

confidence: 97%

Section: Small and Large Arterial Compliancementioning

confidence: 99%

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

Riess

Haykowsky

Lawrance

et al. 2014

Appl. Physiol. Nutr. Metab.

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“…Resting heart rate, blood pressure, and small and large artery compliance were assessed noninvasively using computerized arterial pulse waveform analysis (Hypertension Diagnostics, Eagan, MN) as previously described (17). Briefly, this technique incorporates applanation tonometry placement of the transducer over the radial artery.…”

Section: Small and Large Artery Compliancementioning

confidence: 99%

Pulmonary Oxygen Uptake and Heart Rate Kinetics During the Six-Minute Walk Test in Transplant Recipients

et al. 2008

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“…Kidney transplant recipients (KTRs) generally have an impaired skeletal muscle strength and exercise capacity. 1 , 2 Loss of muscle mass is an important factor adversely influencing muscle strength. Previous studies have shown that reduced muscle mass, impaired muscle strength, and low physical activity are associated with an increased risk of mortality and worse graft outcomes in KTRs.…”

Section: Introductionmentioning

confidence: 99%

Decreased haemoglobin levels are associated with lower muscle mass and strength in kidney transplant recipients

Vinke

Wouters

Stam

et al. 2022

J cachexia sarcopenia muscle

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Background Post-transplant anaemia and reduced muscle mass and strength are highly prevalent in kidney transplant recipients (KTRs). Decreased haemoglobin levels, a marker of anaemia, could adversely affect muscle mass and strength through multiple mechanisms, among others, through diminished tissue oxygenation. We aimed to investigate the association between haemoglobin levels with muscle mass and strength in KTRs. Methods We included stable KTRs from the TransplantLines Biobank and Cohort study with a functional graft ≥1 year post-transplantation. Muscle mass was assessed using 24 h urinary creatinine excretion rate (CER) and bioelectrical impedance analysis (BIA). Muscle strength was assessed with a handgrip strength test using a dynamometer and, in a subgroup (n = 290), with the five-times sit-to-stand (FTSTS) test. We used multivariable linear and logistic regression analyses to investigate the associations of haemoglobin levels with muscle mass and strength. ResultsIn 871 included KTRs [median age 58 (interquartile range (IQR), 48-66)] years; 60% men; eGFR 51 ± 18 mL/min/1.73 m 2 ) who were 3.5 (1.0-10.2) years post-transplantation, the mean serum haemoglobin level was 13.9 ± 1.8 g/dL in men and 12.8 ± 1.5 g/dL in women. Lower haemoglobin levels were independently associated with a lower CER (std. β = 0.07, P = 0.01), BIA-derived skeletal muscle mass (std. β = 0.22, P < 0.001), handgrip strength (std. β = 0.15, P < 0.001), and worse FTSTS test scores (std. β = À0.17, P = 0.02). KTRs in the lowest age-specific and sex-specific quartile of haemoglobin levels had an increased risk of being in the worst age-specific and sex-specific quartile of CER (fully adjusted OR, 2.09; 95% CI 1.15-3.77; P = 0.02), handgrip strength (fully adjusted OR, 3.30; 95% CI 1.95-5.59; P < 0.001), and FTSTS test score (fully adjusted OR, 7.21; 95% CI 2.59-20.05; P < 0.001). Conclusions Low haemoglobin levels are strongly associated with decreased muscle mass and strength in KTRs. Future investigation will need to investigate whether maintaining higher haemoglobin levels may improve muscle mass and strength in KTRs.

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Impaired Arterial Compliance and Aerobic Endurance in Kidney Transplant Recipients

Abstract: Compromised arterial compliance and poor aerobic endurance may partially explain the high incidence of cardiovascular disease in KTR. Interventions demonstrated to improve these parameters may afford substantial clinical benefit in this population.

Cited by 10 publications

References 19 publications

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

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

Pulmonary Oxygen Uptake and Heart Rate Kinetics During the Six-Minute Walk Test in Transplant Recipients

Decreased haemoglobin levels are associated with lower muscle mass and strength in kidney transplant recipients

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