Gibson Cheryl A, Gupta Aditi, Greene J Leon, Lee Jaehoon, Mount Rebecca R, Sullivan Debra K
Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd., MS1020, Kansas City, KS 66160 USA.
Department of Internal Medicine, Division of Nephrology and Hypertension, Kidney Institute, University of Kansas Medical Center, Kansas City, KS USA.
Pilot Feasibility Stud. 2020 Sep 10;6:126. doi: 10.1186/s40814-020-00672-4. eCollection 2020.
Post-transplant weight gain affects 50-90% of kidney transplant recipients adversely affecting survival, quality of life, and risk for diabetes and cardiovascular disease. Diet modification and physical activity may help prevent post-transplant weight gain. Methods for effective implementation of these lifestyle modifications are needed. The objective of this study is to assess the feasibility and acceptability of a remotely delivered nutrition and physical activity intervention among kidney transplant recipients. Secondary aims were to estimate the effectiveness of the intervention in producing changes in physical activity, qualify of life, fruit and vegetable intake, and consumption of whole grains and water from baseline to 6 months.
A randomized controlled study for stable kidney transplant recipients between 6 and 12 months post-transplantation was conducted. Participants were randomly assigned 1:1 to a technology-based, lifestyle modification program (intervention) or to enhanced usual care (control).
The first 10 kidney transplant recipients screened were eligible and randomized into the intervention and control groups with no significant between-group differences at baseline. Health coaching attendance (78%) and adherence to reporting healthy behaviors (86%) were high. All participants returned for final assessments. The weight in controls remained stable, while the intervention arm showed weight gain at 3 and 6 months. Improvements were found for physical activity, quality of life, and fruit and vegetable intake in both groups. All participants would recommend the program to other transplant recipients.
Our data suggest that a remotely delivered televideo nutrition and physical activity intervention is feasible and valued by patients. These findings will aid in the development of a larger, more prescriptive, randomized trial to address weight gain prevention.
Clinicaltrials.gov Identifier NCT03697317. Retrospectively registered on October 5, 2018.
移植后体重增加影响50%-90%的肾移植受者，对生存、生活质量以及糖尿病和心血管疾病风险产生不利影响。饮食调整和体育活动可能有助于预防移植后体重增加。需要有效实施这些生活方式改变的方法。本研究的目的是评估在肾移植受者中远程提供营养和体育活动干预的可行性和可接受性。次要目标是估计该干预在从基线到6个月期间对体育活动、生活质量、水果和蔬菜摄入量以及全谷物和水的消耗量产生变化方面的有效性。
对移植后6至12个月的稳定肾移植受者进行了一项随机对照研究。参与者按1:1随机分配到基于技术的生活方式改变计划（干预组）或强化常规护理（对照组）。
筛选出的前10名肾移植受者符合条件并随机分为干预组和对照组，基线时组间无显著差异。健康指导参与率（78%）和报告健康行为的依从性（86%）很高。所有参与者均返回进行最终评估。对照组体重保持稳定，而干预组在3个月和6个月时体重增加。两组在体育活动、生活质量以及水果和蔬菜摄入量方面均有改善。所有参与者都会向其他移植受者推荐该计划。
我们的数据表明远程提供的电视视频营养和体育活动干预是可行的且受到患者重视。这些发现将有助于开展一项更大、更具规范性的随机试验以解决体重增加预防问题。
Clinicaltrials.gov标识符NCT03697317。于2018年10月5日进行回顾性注册。
