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意大利肾移植人群的体力活动与肾功能。

Physical activity and renal function in the Italian kidney transplant population.

机构信息

Italian National Transplant Center, Rome, Italy.

Department of Biomedical & Neuromotor Sciences, University of Bologna, Bologna, Italy.

出版信息

Ren Fail. 2020 Nov 10;42(1):1192-1204. doi: 10.1080/0886022X.2020.1847723.

Abstract

BACKGROUND

The well-documented benefits of physical activity (PA) are still poorly characterized in long-term kidney transplant outcome. This study analyzed the impact over a 10-year follow-up of PA on graft function in Italian kidney transplant recipients (KTRs).

METHODS

Since 2002, the Italian Transplant-Information-System collected donor and recipient baseline and transplant-related parameters in KTRs. In 2015, 'penchant for PA' (PA ≥ 30-min, 5 times/week) was added. Stable patients aged ≥18 years at the time of first-transplantation were eligible. KTRs with at least 10-year follow-up were also analyzed. Mixed-effect regression models were used to compare eGFR changes over time in active versus non-active patients.

RESULTS

PA information was available for 6,055 KTRs (active 51.6%, non-active 48.4%). Lower penchant for PA was found in overweight and obese patients (OR = 0.84; OR = 0.48, respectively), in those with longer dialysis vintage (OR = 0.98 every year of dialysis), and older age at transplant. Male subjects showed greater penchant for PA (OR = 1.25). A slower decline of eGFR over time was observed in active KTRs compared to non-active, and this finding was confirmed in the subgroup with at least 10-year follow-up (n = 2,060). After applying the propensity score matching to reduce confounding factors, mixed-effect regression models corroborated such better long-term trend of graft function preservation in active KTRs.

CONCLUSIONS

Penchant for PA is more frequent among male and younger KTRs. Moreover, in our group of Italian KTRs, active patients revealed higher eGFR values and preserved kidney function over time, up to 10-years of follow-up.

摘要

背景

体力活动(PA)的诸多益处已得到充分证实,但在长期肾脏移植结局方面仍描述不足。本研究分析了意大利肾脏移植受者(KTR)在 10 年随访期间 PA 对移植物功能的影响。

方法

自 2002 年以来,意大利移植信息系统收集了 KTR 供体和受体的基线及移植相关参数。2015 年,添加了“对 PA 的偏好”(PA≥30 分钟,每周 5 次)。首次移植时年龄≥18 岁且病情稳定的患者符合条件。还对至少有 10 年随访的 KTR 进行了分析。使用混合效应回归模型比较了活跃患者和非活跃患者的 eGFR 随时间的变化。

结果

6055 名 KTR 有 PA 信息(活跃者占 51.6%,非活跃者占 48.4%)。超重和肥胖患者(OR=0.84;OR=0.48)、透析时间较长的患者(OR=每年透析时间延长 0.98 年)和移植时年龄较大的患者对 PA 的偏好较低。男性患者对 PA 的偏好更高(OR=1.25)。与非活跃患者相比,活跃患者的 eGFR 随时间的下降速度较慢,这一发现在至少随访 10 年的亚组(n=2060)中得到了证实。应用倾向评分匹配来减少混杂因素后,混合效应回归模型证实了活跃 KTR 具有更好的长期保存移植物功能的趋势。

结论

在意大利 KTR 中,男性和年轻的 KTR 更倾向于进行 PA。此外,活跃患者在我们的意大利 KTR 组中表现出更高的 eGFR 值和随时间推移的肾功能保存,随访时间长达 10 年。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a9a/7717861/737d89cf2768/IRNF_A_1847723_F0001_B.jpg

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