Department of Paediatric Medicine, Women and Children's Division, Oslo University Hospital Rikshospitalet, Postboks 4950, Nydalen, 0424 Oslo, Norway.
Pediatr Nephrol. 2011 Nov;26(11):2041-9. doi: 10.1007/s00467-011-1898-6. Epub 2011 May 4.
Limited knowledge exists on cardiorespiratory fitness (CR fitness) in adults having a renal transplant (Rtx) during childhood. Our aim was to assess CR fitness (V0(2peak)) with a maximal treadmill test in former Rtx children reaching adulthood (ped-tx, n = 31), compared to patients Rtx as adults (adult-tx, n = 17) and healthy controls (HC, n = 36). Median age was 26.9 (19-41), 28.6 (23.5-34) and 33.5 (20-42) years, respectively. Median time since first Rtx was 18.1 (7-29) and 3.7 (1.2-12.6) years. Body composition was measured by dual-energy X-ray absorptiometry (DXA). V0(2peak) was median 37.9 (12.5-56.3), 40.8 (26.5-57.5), and 44.4 (29.5-65.6) ml kg (-1)min (-1) in the ped-tx, adult-tx, and HC, respectively. Ped-tx had significantly lower V0(2peak) compared to HC (p = 0.01). Adult-tx had higher exercise capacity (test duration) compared to ped-tx (median 10.5 (7.5-16) and 9 (6-14) min, respectively (p = 0.016). In multiple linear regression analysis, test duration, fat-free mass (FFM, kg) and Hgb (g/dl) were significant predictors of V0(2peak) explaining 86% of its variance. There was no significant difference between ped-tx and adult-tx in V0(2peak.) CR fitness depicts long-term health outcome in Rtx patients both in regard to physical functioning and is a plausible indirect marker of CV health.
在儿童时期接受过肾移植 (Rtx) 的成年人中,心肺适能 (CR 适应性) 的相关知识有限。我们的目的是评估达到成年期的前肾移植儿童 (ped-tx,n=31) 的 CR 适应性 (V0(2peak)),并将其与成年后接受 Rtx 的患者 (adult-tx,n=17) 和健康对照组 (HC,n=36) 进行比较。中位年龄分别为 26.9 (19-41)、28.6 (23.5-34) 和 33.5 (20-42) 岁。中位首次 Rtx 后时间分别为 18.1 (7-29) 和 3.7 (1.2-12.6) 年。身体成分通过双能 X 射线吸收法 (DXA) 进行测量。V0(2peak) 在 ped-tx、adult-tx 和 HC 中的中位数分别为 37.9 (12.5-56.3)、40.8 (26.5-57.5) 和 44.4 (29.5-65.6) ml·kg(-1)·min(-1)。与 HC 相比,ped-tx 的 V0(2peak)显著降低 (p=0.01)。与 ped-tx 相比,adult-tx 的运动能力 (测试持续时间) 更高 (中位数分别为 10.5 (7.5-16) 和 9 (6-14) 分钟,p=0.016)。在多元线性回归分析中,测试持续时间、去脂体重 (FFM,kg) 和 Hgb (g/dl) 是 V0(2peak) 的显著预测因子,可解释其 86%的变异性。在 V0(2peak)方面,ped-tx 和 adult-tx 之间无显著差异。CR 适应性反映了 Rtx 患者的长期健康结果,无论是在身体功能方面,还是作为 CV 健康的间接标志物方面都具有一定意义。