Physical activity and renal function in the Italian kidney transplant population

Abstract

Background: The well-documented benefits of physical activity (PA) are still poorly characterized in long-term kidney transplant outcome. This study analyzed the impact over a 10-year follow-up of PA on graft function in Italian kidney transplant recipients (KTRs). Methods: Since 2002, the Italian Transplant-Information-System collected donor and recipient baseline and transplant-related parameters in KTRs. In 2015, 'penchant for PA' (PA ! 30-min, 5 times/week) was added. Stable patients aged !18 years at the time of first-transplantation were eligible. KTRs with at least 10-year follow-up were also analyzed. Mixed-effect regression models were used to compare eGFR changes over time in active versus non-active patients. Results: PA information was available for 6,055 KTRs (active 51.6%, non-active 48.4%). Lower penchant for PA was found in overweight and obese patients (OR ¼ 0.84; OR ¼ 0.48, respectively), in those with longer dialysis vintage (OR ¼ 0.98 every year of dialysis), and older age at transplant. Male subjects showed greater penchant for PA (OR ¼ 1.25). A slower decline of eGFR over time was observed in active KTRs compared to non-active, and this finding was confirmed in the subgroup with at least 10-year follow-up (n ¼ 2,060). After applying the propensity score matching to reduce confounding factors, mixed-effect regression models corroborated such better long-term trend of graft function preservation in active KTRs. Conclusions: Penchant for PA is more frequent among male and younger KTRs. Moreover, in our group of Italian KTRs, active patients revealed higher eGFR values and preserved kidney function over time, up to 10-years of follow-up.

Physical Inactivity: A Modifiable Risk Factor for Morbidity and Mortality in Kidney Transplantation

“…The lowest inclination to physical activity was observed in overweight and obese subjects, as well as in patients with longer dialysis vintage and older age at transplant. Noticeably, the propensity score showed that graft function was better preserved among active KT recipients [ 19 ].…”

Kidney Transplant Recipients’ Weight Change and their Behaviors and Attitudes Related to Diet and Exercise

“…Previous studies found patients on the transplant waitlist did not consider exercise to be a factor in the health of their kidneys [19]. Recent work has shown an association between exercise and slower post-transplant eGFR decline [20]. Nearly all (98%) of our surveyed patients reported exercise was important to the health of their kidneys and 90% believed maintaining a healthy weight was important to the health of their kidneys.…”

Physical Activity Behaviour in Solid Organ Transplant Recipients: Proposal of Theory-Driven Physical Activity Interventions

“…Many solid organ transplant recipients lead a sedentary, physically inactive life [7][8][9][10][11]. Sedentary behaviour refers to "any waking behaviour characterized by an energy expenditure of ≤1.5 metabolic equivalents, while in a sitting, reclining, or lying posture" [12].…”

“…Both in the general and the transplant population, physical activity and physical fitness are established risk factors for cardiovascular disease [10,28,[34][35][36][37][38], which currently represents one of the leading causes of death following transplantation [30,33,39,40]. Observational studies in kidney transplant recipients have suggested that physical activity may contribute to preservation of graft function [9,41], although intervention studies still need to confirm such findings. Lastly, in the general population, regular engagement in physical activity enhances immunosurveillance against pathogens [42] and adverse outcome following SARS-CoV-2 infection [43].…”