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一种针对肥胖肾移植受者的新颖且个性化的康复计划。

A novel and personalized rehabilitation program for obese kidney transplant recipients.

作者信息

Tzvetanov I, West-Thielke P, D'Amico G, Johnsen M, Ladik A, Hachaj G, Grazman M, Heller R U, Fernhall B, Daviglus M L, Solaro R J, Oberholzer J, Gallon L, Benedetti E

机构信息

Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA.

Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, Illinois, USA.

出版信息

Transplant Proc. 2014 Dec;46(10):3431-7. doi: 10.1016/j.transproceed.2014.05.085.

Abstract

INTRODUCTION

Physical rehabilitation programs for kidney transplant recipients are not routinely personalized to patients' physical and emotional health, which could result in a potentially limited health impact, shorter-term participation, and an overall low success rate.

MATERIALS AND METHODS

We conducted an internal review board-approved randomized prospective study involving a 12-month supervised multidisciplinary rehabilitation program (GH method) initiated after kidney transplantation in obese recipients (body mass index >30). The new method incorporates 3 major components: physical exercise, behavioral interventions, and nutritional guidance. We compared 9 patients who underwent supervised rehabilitation with 8 patients who underwent standard care. Patients were followed up after the start of the intervention, and multiple assessments were performed.

RESULTS

The adherence to training and follow-up was 100% in the intervention group, compared with 25% at 12 months in the control group. There was a trend for a higher glomerular filtration rate in the intervention group compared with the control group (55.5 ± 18.6 mL/min/1.73 m(2) vs 38.8 ± 18.9 mL/min/1.73 m(2), P = .06). The quality of life (SF-36) mean score improved more in the intervention group compared with the control group (583 ± 13 vs 436 ± 22, P = .008). There was a significantly higher employment rate in the intervention group, 77.7% at 12 months compared with 12.5% in the control group (P = .02).

CONCLUSIONS

Our preliminary results suggest that this comprehensive approach to physical rehabilitation can improve adherence, kidney function, quality of life, and employment rate for obese patients after kidney transplantation.

摘要

引言

肾移植受者的身体康复计划通常未根据患者的身体和情绪健康进行个性化定制,这可能导致对健康的影响有限、短期参与度低以及总体成功率不高。

材料与方法

我们开展了一项经内部审查委员会批准的随机前瞻性研究,该研究涉及一项为期12个月的、在肥胖受者(体重指数>30)肾移植后启动的多学科监督康复计划(GH方法)。新方法包含3个主要组成部分:体育锻炼、行为干预和营养指导。我们将9名接受监督康复的患者与8名接受标准护理的患者进行了比较。在干预开始后对患者进行随访,并进行了多次评估。

结果

干预组的训练和随访依从率为100%,而对照组在12个月时为25%。与对照组相比,干预组的肾小球滤过率有升高趋势(55.5±18.6毫升/分钟/1.73平方米对38.8±18.9毫升/分钟/1.73平方米,P = 0.06)。与对照组相比,干预组的生活质量(SF - 36)平均得分改善更多(583±13对436±22,P = 0.008)。干预组的就业率显著更高,12个月时为77.7%,而对照组为12.5%(P = 0.02)。

结论

我们的初步结果表明,这种综合的身体康复方法可以提高肥胖肾移植患者的依从性、肾功能、生活质量和就业率。

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