Lorenz Elizabeth C, Amer Hatem, Dean Patrick G, Stegall Mark D, Cosio Fernando G, Cheville Andrea L
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.
Clin Transplant. 2015 Jun;29(6):560-8. doi: 10.1111/ctr.12553. Epub 2015 May 26.
The majority of kidney transplant recipients die from cardiovascular events. Physical activity may be a modifiable risk factor for cardiovascular disease following transplant. The goal of our study was to examine adherence to a physical activity intervention following kidney transplant and its impact on metabolic parameters. All patients who received a kidney transplant at our center between 12/2010 and 12/2011 received usual care (n = 162), while patients transplanted between 12/2011 and 1/2013 received a 90-day pedometer-based physical activity intervention (n = 145). Metabolic parameters were assessed at four and 12 months post-transplant. Baseline demographics and clinical management were similar between cohorts. Adherence to the prescription was 36.5%. Patients in the physical activity cohort had lower systolic and diastolic blood pressure four months post-transplant compared to the usual care cohort (122 ± 18 vs. 126 ± 16 mmHg, p = 0.049 and 73 ± 10 vs. 77 ± 9, p = 0.004) and less impaired fasting glucose (20.7% vs. 30.9%, p = 0.04). Twelve-month outcomes were not different between cohorts. Over one-third of our cohort adhered to a pedometer-based physical activity intervention following kidney transplant, and the intervention was associated with improved metabolic parameters. Further study of post-transplant exercise interventions and methods to optimize long-term adherence are needed.
大多数肾移植受者死于心血管事件。身体活动可能是移植后心血管疾病的一个可改变的风险因素。我们研究的目的是检查肾移植后对身体活动干预的依从性及其对代谢参数的影响。2010年12月至2011年12月期间在我们中心接受肾移植的所有患者接受常规护理(n = 162),而2011年12月至2013年1月期间接受移植的患者接受了为期90天的基于计步器的身体活动干预(n = 145)。在移植后4个月和12个月评估代谢参数。两组之间的基线人口统计学和临床管理相似。对处方的依从率为36.5%。与常规护理组相比,身体活动组的患者在移植后4个月时收缩压和舒张压较低(122±18 vs. 126±16 mmHg,p = 0.049;73±10 vs. 77±9,p = 0.004),空腹血糖受损情况较轻(20.7% vs. 30.9%,p = 0.04)。两组之间12个月的结果没有差异。我们队列中超过三分之一的患者在肾移植后坚持基于计步器的身体活动干预,并且该干预与改善的代谢参数相关。需要进一步研究移植后的运动干预和优化长期依从性的方法。