130公里公路自行车赛后肾移植和肝移植受者的肾功能
Renal Function in Kidney and Liver Transplant Recipients After A 130-km Road Cycling Race.
作者信息
Mosconi Giovanni, Roi Giulio Sergio, Totti Valentina, Zancanaro Marco, Tacconi Alessandra, Todeschini Paola, Ramazzotti Eric, Di Michele Rocco, Trerotola Manuela, Donati Carlo, Nanni Costa Alessandro
机构信息
Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì, Italy.
Isokinetic Medical Group, Bologna, Italy.
出版信息
Transplant Direct. 2015 Oct 19;1(9):e36. doi: 10.1097/TXD.0000000000000546. eCollection 2015 Oct.
BACKGROUND
A few patients, after receiving solid organ transplantation, return to performing various sports and competitions; however, at present, data no study had evaluated the effects of endurance cycling races on their renal function.
METHODS
Race times and short form (36) health survey questionnaires of 10 kidney transplant recipients (KTR) and 8 liver transplant recipients (LTR) transplanted recipients involved in a road cycling race (130 km) were compared with 35 healthy control subjects (HCS), also taking laboratory blood and urine tests the day before the race, at the end of the race, and 18 to 24 hours after competing.
RESULTS
The 3 groups showed similar race times (KTR, 5 hours 59 minutes ± 0 hours 39 minutes; LTR, 6 hours 20 minutes ± 1 hour 11 minutes; HCS, 5 hours 40 minutes ± 1 hour 28 minutes), similar short form (36) health survey scores, and similar trend of laboratory parameters which returned to baseline after 18 to 24 hours. After the race, there was an increase in creatinine (0.24 mg/dL; effect size [ES] = 0.78; P < 0.001), urea (22 mg/dL; ES = 1.42; P < 0.001), and a decrease of estimated glomerular filtration rate (-17 mL/min; ES = 0.85; P < 0.001). The increase of blood uric acid was more remarkable in HCS and KTR (2.3 mg/dL; ES = 1.39; P < 0.001). The KTR showed an increase of microalbuminuria (167.4 mg/L; ES = 1.20; P < 0.001) and proteinuria (175 mg/mL; ES = 0.97; P < 0.001) similar to LTR (microalbuminuria: 176.0 mg/L; ES = 1.26; P < 0.001; proteinuria: 213 mg/mL; ES = 1.18; P < 0.001), with high individual variability. The HCS had a nonsignificant increase of microalbuminuria (4.4 mg/L; ES = 0.03; P = 0.338) and proteinuria (59 mg/mL; ES = 0.33; P = 0.084).
CONCLUSIONS
Selected and well-trained KTR and LTR patients can participate to an endurance cycling race showing final race times and temporary modifications of kidney function similar to those of HCS group, despite some differences related to baseline clinical conditions and pharmacological therapies. Patients involved in this study represent the upper limit of performance currently available for transplant recipients and cannot be considered representative of the entire transplanted population.
背景
少数实体器官移植受者在接受移植后恢复了各种运动和比赛；然而，目前尚无研究评估耐力自行车比赛对其肾功能的影响。
方法
将10名参与公路自行车比赛（130公里）的肾移植受者（KTR）和8名肝移植受者（LTR）的比赛时间和简短健康调查问卷（36项）与35名健康对照者（HCS）进行比较，并在比赛前一天、比赛结束时以及比赛后18至24小时进行实验室血液和尿液检测。
结果
三组的比赛时间相似（KTR，5小时59分钟±0小时39分钟；LTR，6小时20分钟±1小时11分钟；HCS，5小时40分钟±1小时28分钟），简短健康调查问卷得分相似，实验室参数在18至24小时后恢复到基线的趋势相似。比赛后，肌酐升高（0.24mg/dL；效应量[ES]=0.78；P<0.001），尿素升高（22mg/dL；ES=1.42；P<0.001），估计肾小球滤过率降低（-17mL/min；ES=0.85；P<0.001）。HCS和KTR的血尿酸升高更为显著（2.3mg/dL；ES=1.39；P<0.001）。KTR的微量白蛋白尿（167.4mg/L；ES=1.20；P<0.001）和蛋白尿（175mg/mL；ES=0.97；P<0.001）升高与LTR相似（微量白蛋白尿：167.4mg/L；ES=1.20；P<0.001；蛋白尿：213mg/mL；ES=1.18；P<0.001），个体差异较大。HCS的微量白蛋白尿（4.4mg/L；ES=0.03；P=0.338）和蛋白尿（59mg/mL；ES=0.33；P=0.084）升高不显著。
结论
经过挑选和良好训练的KTR和LTR患者可以参加耐力自行车比赛，其最终比赛时间和肾功能的暂时变化与HCS组相似，尽管与基线临床状况和药物治疗存在一些差异。本研究中的患者代表了目前移植受者可达到的表现上限，不能被视为整个移植人群的代表。
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