Prevalence and Correlates of Accelerometer-Based Physical Activity and Sedentary Time Among Kidney Transplant Recipients

Abstract

Background:Physical activity is recommended for kidney transplant recipents as it may improve outcomes including mortality, exercise capacity, muscle strength, and health-related quality of life.Objective:The objective of this study was to examine accelerometer-based physical activity and sedentary time profiles among kidney transplant recipients and examine possible demographic and clinical correlates of physical activity and sedentary time.Design:Cross-sectional.Setting:Edmonton, Alberta, Canada.Patients:Kidney transplant recipients were recruited (N = 1,284) from the Northern Alberta Renal Program’s Nephrology Information System database (1993-2016).Measurements:Participants wore an ActiGraph GT3X+ accelerometer on their hip during waking hours for seven consecutive days.Methods:Kidney transplant recipients (1993-2016) recruited from the Northern Alberta Renal Program’s Nephrology Information System database wore an accelerometer and completed a self-reported questionnaire. Multiple linear regression was used to determine associations between activity level, demographic, and clinical characteristics.Results:Participants’ (n = 133; 11% response rate) mean age (SD) was 58 (14) years and 56% were female. Mean total sedentary time was 9.4 (1.4) hours per day; total moderate-to-vigorous physical activity (MVPA) time was 20.7 (19.6) minutes per day. MVPA was significantly associated with age where each additional year was associated with 0.48 fewer min/day (ie, ~30 seconds) (unstandardized beta: B = −0.48 min/day, 95% confidence interval [95% CI]: −0.75, −0.22). Sedentary time was significantly associated with age (B = 1.0 min/day, 95% CI: 0.03, 1.9), body mass index (B = 2.7 min/day, 95% CI: 0.2, 5.13), education (B = 39.1 min/day, 95% CI: 12.3, −65.8), and inversely associated with income (B = −44.9 min/day, 95% CI: −73.1, −16.8).Limitations:Limitations include the cross-sectional design, poor response rate, and limited generalizability of the results.Conclusions:Kidney transplant recipients showed high volumes of sedentary time and low volumes of health-enhancing physical activity. Understanding correlates of these behaviors may aid in the development of interventions to favorably change these behaviors.

Relationships of accelerometer‐determined physical activity with obesity, hypertension, diabetes, dyslipidemia, and health‐related quality of life in patients after liver transplantation

“…These measures of PA were also associated with PCS and four subscales of the SF-8, but not with the MCS of the SF-8.In the present study, the number of steps taken, but not the amount of moderate-to-vigorous PA performed, correlated with hypertension and obesity. Our findings are consistent with those of two other studies of transplant recipients12,13 that showed associations between objectively measured PA level and BMI. Internationally, a moderate-to-vigorous PA level of ≥ 150 min/week is considered to be effective in the prevention of metabolic syndrome and its components,26 but three-quarters of our participants failed to achieve this level.…”

“…11 Four other studies used accelerometers to measure PA and to evaluate the relationship between PA level and BMI or metabolic abnormalities in patients following transplantation. 12,13 A study of lung transplant patients revealed that obese/overweight patients took a significantly lower number of steps per day than normal-weight controls, but the dietary intake of the two groups did not differ significantly. 12 A study of renal transplant patients aimed to determine the predictors of four PA indicators and found that high BMI was inversely associated with light PA and was positively associated with sedentary time.…”

“…A study of lung transplant patients revealed that obese/overweight patients took a significantly lower number of steps per day than normal‐weight controls, but the dietary intake of the two groups did not differ significantly 12 . A study of renal transplant patients aimed to determine the predictors of four PA indicators and found that high BMI was inversely associated with light PA and was positively associated with sedentary time 13 . In female heart transplantation patients, low PA was associated with high prevalence of hypertension, dyslipidemia, and obesity 14 .…”

“…12 A study of renal transplant patients aimed to determine the predictors of four PA indicators and found that high BMI was inversely associated with light PA and was positively associated with sedentary time. 13 In female heart transplantation patients, low PA was associated with high prevalence of hypertension, dyslipidemia, and obesity. 14 As for patients that had undergone LT, only one small previous study measured PA using accelerometry (n = 8), and measures of PA, such as walking speed, did not differ between LT patients and healthy controls.…”

Maximal Exercise Capacity in Chronic Kidney Disease Stage 4–5 Patients Transitioning to Renal Replacement Therapy or Continuing Conservative Care: A Longitudinal Follow-Up Study

“…The criteria for kidney transplant eligibility were strict in 1987 compared to contemporary criteria. Second, the patients in the previous studies were more specifically selected, whereas the patients in our study were recruited consecutively representing a real-world cohort of patients known to lead a sedentary life style [16]. Third, the dialysis vintage in the transplant recipients of our study was substantial (mean >2.5 years), possibly contributing to the poor MEC at the follow-up ergometry test.…”