Sp768comparing Glycaemic Benefits of Active Versus Passive Lifestyle Intervention in Kidney Allograft Recipients (Caviar): A Randomised Controlled Trial

Kuningas, Kulli; Driscoll, Joanne; Mair, Reena; Smith, Helen; Dutton, Mary Ann; Day, Ed; Sharif, Adnan

doi:10.1093/ndt/gfz103.sp768

Cited by 5 publications

(10 citation statements)

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“…In terms of physical activity, patients were encouraged to increase their performance and kept a training diary. This study did not con rm a different impact of active versus passive intervention on insulin sensitivity or secretion (20). The Dutch multicenter randomized study ACT (The Active Care after Transplantation) is currently underway, comparing 3 groups of patients (classic care, physical exercise intervention and combination of diet and exercise) with the primary aim to assess the impact of lifestyle changes on quality of life as well as degree of physical condition, adipose tissue and cardio-metabolic risk factors such as blood pressure, lipids, glucose metabolism (21).…”

Section: Discussioncontrasting

confidence: 70%

“…However, the reduction in body weight, BMI, waist circumference and lipid pro le parameters did not reach statistically signi cant in the multivariate model. In the CAVIAR study, the active intervention group achieved signi cant progress in weight and fat mass reduction in contrast to the passive group, which clearly contributes to improving the cardio-metabolic risk pro le of these patients (20). We also demonstrated a signi cant difference in waist circumference value reduction between patients in the intervention group, which was achieved by the subgroup with the highest level of sports exertion, which supports a direct relationship between the degree of physical activity and cardio-metabolic risk.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Regular Physical Activity and Lifestyle Changes on Insulin Resistance in Patients after Kidney Transplantation

Graňák

Vnučák

Skálová

et al. 2021

Preprint

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Introduction: Insulin resistance (IR) at the time of kidney transplant (KT) is the most significant risk factor for the development of post-transplant diabetes mellitus (PTDM) and is a strong predictor of cardiovascular morbidity and mortality in patients after KT. It is possible to improve long-term survival of grafts and patients by influencing just modifiable risk factors, including obesity and the associated IR. The aim of this work is to determine the effect of regular physical activity and lifestyle changes on IR and other risk factors for PTDM in patients after KT.Material and methods: The primary goal was to complete at least 150 minutes of moderate intensity physical exertion per week. Study group (n = 22) performed an aerobic or combined (aerobic + anaerobic) type of sports activity. Monitoring was provided by a sports tracker (Xiaomi Mi Band 4 compatible with Mi Fit mobile application). Control group was consisted of 22 stable patients after KT. Patients in both groups have the same immunosuppressive protocol. The duration of follow-up was 6 months.Results: There were significantly lower waist circumference (P = 0.0437, P = 0.0372), better graft function (P = 0.0036, P = 0.0137), lower value of fasting blood glucose (P = 0.0016, P = 0.0003), C-peptide (P = 0.0447, P = 0014) in the 3rd and 6th month of monitoring and lower low-density lipoprotein at 6 months (P = 0.0444) in the observed group compared to the control group. IR was statistically significantly lower at 6 months (P = 0.0202) and fasting blood glucose at 3 and 6 months (P = 0.0227) in the observed group. In the monitored group, the subgroup performing intensive training achieved a significant additional effect on the reduction of waist circumference (P = 0.0173). Conclusion: In our study, we confirmed a significant effect of regular physical activity in preventing the development of IR and impaired fasting glucose in patients after KT. It is necessary to perform at least 150 minutes of medium-intensity aerobic or combined sport effort per week to achieve this goal.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Effect of Regular Physical Activity and Lifestyle Changes on Insulin Resistance in Patients after Kidney Transplantation

Graňák

Vnučák

Skálová

et al. 2021

Preprint

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“…(2014) showed no significant between‐group difference in body mass index (BMI) when comparing 12 months of exercise and nutrition counselling to usual care in obese KTRs. A RCT compared the effects of 6 months of face‐to‐face nutrition counselling and physical activity by a renal dietician, to usual care on insulin sensitivity in new KTRs (Kuningas et al ., 2019). Whilst there was no change in insulin sensitivity, the authors reported a significant mean between‐group difference in body weight over the 6‐month study (−2.47 kg [−4.01 to −0.92]; Kuningas et al ., 2019).…”

Section: Introductionmentioning

confidence: 99%

Usability and experience testing to refine an online intervention to prevent weight gain in new kidney transplant recipients

Castle

Greenwood

Chilcot

et al. 2020

British J Health Psychol

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Objectives. Weight gain in the first year following kidney transplantation increases the risk of adverse health outcomes. Currently, there is no recognized intervention available to prevent weight gain after kidney transplantation. An online kidney transplant-specific resource, entitled Exercise in Renal Transplant Online (ExeRTiOn), has been co-created by a multi-professional team, including patients, to assist with weight prevention. This study aimed to evaluate patient and health care professional usability and experience of the ExeRTiOn online resource. Design. Qualitative study utilizing 'Think-Aloud' and semi-structured interviews. Methods. Participants (n = 17) were purposively sampled to include new kidney transplant recipients (n = 11) and transplant health care professionals (n = 6). Kidney transplant recipient participants were from a spread of physical activity levels based on scores from the General Practice Physical Activity Questionnaire (GPPAQ). 'Think-Aloud' interviews assessed the usability of ExeRTiOn. Semi-structured interviews explored participants' experience of ExeRTiOn, weight gain, and physical activity. The data set were analysed thematically. Participant characteristics, including login data and self-reported body weight, were collected. Results. Data analyses identified valued intervention content and usability aspects which were summarized by two themes. The first theme 'You need to know how to manage yourself' included subthemes: (1) the resource filled a guidance gap, (2) expert patient content resonated, and (3) the importance of goal setting and monitoring progress. The second theme 'room for improvement' included subthemes: (2) web support and (2) content and operational change suggestions.

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“…The types of dietary interventions varied, although there were three broad models of delivery: personalised interventions; multidisciplinary team (MDT) interventions; and food‐based interventions. Personalised interventions included: telehealth to support dietary self‐management 20,21 ; individualised nutrition and exercise counselling 22 ; lifestyle advice using self‐monitoring 23 ; individualised nutrition education 24 ; and dietary intervention tailored to patient‐specific barriers 25,26 . MDT interventions included: cooking classes plus an exercise programme 27 and an integrated (hospital and community) care programme 28 .…”

Section: Resultsmentioning

confidence: 99%

“…All four cluster RCTs were rated high risk of bias relating to the timing of recruitment of the clusters. Other issues to highlight are: (i) very few studies reported whether confounding factors such as lipid‐lowering drugs, antihypertensive and steroid medications were equally balanced across groups at baseline or controlled for in analyses and (ii) none of the studies that reported on clinical outcomes were adequately powered to detect changes in such endpoints 21,23,28 …”

Section: Resultsmentioning

confidence: 99%

Dietary interventions with dietitian involvement in adults with chronic kidney disease: A systematic review

Brown

Williams

Mafrici

et al. 2021

J Human Nutrition Diet

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Background A comprehensive evidence base is needed to support recommendations for the dietetic management of adults with chronic kidney disease (CKD). The present study aimed to determine the effect of dietary interventions with dietitian involvement on nutritional status, well‐being, kidney risk factors and clinical outcomes in adults with CKD. Methods Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, PsycINFO and EMBASE.com were searched from January 2000 to November 2019. Intentional weight loss and single nutrient studies were excluded. Risk of bias was assessed using the Cochrane risk‐of‐bias tool. Effectiveness was summarised using the mean difference between groups for each outcome per study. Results Twelve controlled trials (1906 participants) were included. High fruit and vegetable intake, as well as a multidisciplinary hospital and community care programme, slowed the decline in glomerular filtration rate in adults with stage 3–4 CKD. Interventions addressing nutrition‐related barriers increased protein and energy intake in haemodialysis patients. A Mediterranean diet and a diet with high n‐3 polyunsaturated fatty acids improved the lipid profile in kidney transplant recipients. Conclusions A limited number of studies suggest benefits as a result of dietary interventions that are delivered by dietitians and focus on diet quality. We did not identify any studies that focussed on our primary outcome of nutritional status or studies that examined the timing or frequency of the nutritional assessment. This review emphasises the need for a wider body of high‐quality evidence to support recommendations on what and how dietetic interventions are delivered by dietitians for adults with CKD.

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Sp768comparing Glycaemic Benefits of Active Versus Passive Lifestyle Intervention in Kidney Allograft Recipients (Caviar): A Randomised Controlled Trial

Cited by 5 publications

References 0 publications

Effect of Regular Physical Activity and Lifestyle Changes on Insulin Resistance in Patients after Kidney Transplantation

Effect of Regular Physical Activity and Lifestyle Changes on Insulin Resistance in Patients after Kidney Transplantation

Usability and experience testing to refine an online intervention to prevent weight gain in new kidney transplant recipients

Dietary interventions with dietitian involvement in adults with chronic kidney disease: A systematic review

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