Physical Activity and Renal Transplantation

Abstract

Renal transplantation is burdened by high cardiovascular risk because of increased prevalence of traditional and disease-specific cardiovascular risk factors and, consequently, patients are affected by greater morbidity and mortality. In renal transplanted patients, healthy lifestyle and physical activity are recommended to improve overall morbidity and cardiovascular outcomes. According to METs (Metabolic Equivalent Task; i.e. the amount of energy consumed while sitting at rest), physical activities are classified as sedentary (<3.0 METs), of moderate-(3.0 to 5.9 METs) or vigorous-intensity (≥6.0 METs). Guidelines suggest for patients with chronic kidney disease an amount of physical activity of at least 30 minutes of moderate-intensity activity five times per week (min 450 MET-minutes/week). Data on physical activity in renal transplanted patients, however, are limited and have been mainly obtained by mean of non-objective methods. Available data suggest that physical activity is low either at the start or during renal transplantation and this may be associated with poor patient and graft outcomes. Therefore, in renal transplanted patients more data on physical activity obtained with objective, accelerometer-based methods are needed. In the meanwhile, physical activity have to be considered as an essential part of the medical care for renal transplanted recipients.

Female Specific Association of Low Insulin-Like Growth Factor 1 (IGF1) Levels with Increased Risk of Premature Mortality in Renal Transplant Recipients

“…Secondly, the significant association between IGF1 and the use of calcineurin inhibitors should be viewed in this context as well. The target of these drugs, calcineurin, has been described as a regulator of muscle mass, although it should be noted that much is still unknown about the underlying mechanisms [54][55][56]. Thirdly, the observed strongly significant association of higher plasma IGF1 levels with lower risk for infectious disease-related mortality may be interesting as well in this regard.…”

Assessment of physical performance and quality of life in kidney-transplanted patients: a cross-sectional study

“…Moreover, we did not investigate other important determinants of physical performance status, such as physical activity and lifestyle, which are other major contributors to physical and mental wellness [29]. …”

Comportamento da variabilidade da frequência cardíaca e da capacidade funcional de acordo com o tempo de transplante renal

“…Em nosso estudo, cerca de 43% dos transplantados renais eram sedentários. Embora a diminuição do nível de atividade física nesse grupo de pacientes seja frequente, a persistência da uremia 14 , o uso de corticosteroides 17 e de imunossupressores 18 , associados à presença de comorbidades como hipertensão, obesidade e diabetes 19 , têm sido descritos como prováveis fatores que podem contribuir para o sedentarismo e o baixo desempenho funcional de transplantados renais. Para os transplantados com maior tempo de TX se desconhece sobre esse comportamento 19 .…”

“…Embora a diminuição do nível de atividade física nesse grupo de pacientes seja frequente, a persistência da uremia 14 , o uso de corticosteroides 17 e de imunossupressores 18 , associados à presença de comorbidades como hipertensão, obesidade e diabetes 19 , têm sido descritos como prováveis fatores que podem contribuir para o sedentarismo e o baixo desempenho funcional de transplantados renais. Para os transplantados com maior tempo de TX se desconhece sobre esse comportamento 19 . Os participantes de nosso estudo apresentaram tempo de TX superior a 100 meses e esse achado foi acompanhado de níveis séricos de creatinina relativamente elevados e TFG inferior a 60mL/min/1,73m 2 , sugestivos de declínio da função renal e do estado urêmico característico da DRC.…”