Ponticelli Claudio, Favi Evaldo
Nephrology, Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Kidney Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
J Pers Med. 2021 Sep 18;11(9):927. doi: 10.3390/jpm11090927.
In patients with chronic kidney disease, sedentary behavior is widely recognized as a significant risk factor for cardiovascular disease, diabetes, obesity, osteoporosis, cancer, and depression. Nevertheless, the real impact of physical inactivity on the health of kidney transplant (KT) recipients remains uncertain. Over the last decade, there has been a renewed interest in exploring the effects of regular physical exercise on transplant-related outcomes. There is now mounting evidence that physical activity may reduce the burden of cardiovascular risk factors, preserve allograft function, minimize immunosuppression requirement, and ameliorate the quality of life of KT recipients. Many positive feedbacks can be detected in the early stages of the interventions and with a minimal exercise load. Despite these encouraging results, the perceived role of physical activity in the management of KT candidates and recipients is often underrated. The majority of trials on exercise training are small, relatively short, and focused on surrogate outcomes. While waiting for larger studies with longer follow-up, these statistical limitations should not discourage patients and doctors from initiating exercise and progressively increasing intensity and duration. This narrative review summarizes current knowledge about the deleterious effects of physical inactivity after KT. The benefits of regular physical exercise are also outlined.
在慢性肾脏病患者中，久坐行为被广泛认为是心血管疾病、糖尿病、肥胖、骨质疏松、癌症和抑郁症的重要危险因素。然而，身体活动不足对肾移植（KT）受者健康的实际影响仍不确定。在过去十年中，人们对探索规律体育锻炼对移植相关结局的影响重新产生了兴趣。现在有越来越多的证据表明，体育活动可能减轻心血管危险因素的负担，保护移植肾的功能，减少免疫抑制需求，并改善KT受者的生活质量。在干预的早期阶段，以最小的运动负荷就能检测到许多积极的反馈。尽管有这些令人鼓舞的结果，但体育活动在KT候选者和受者管理中的作用往往被低估。大多数运动训练试验规模较小、持续时间相对较短，且侧重于替代结局。在等待更大规模、更长随访期的研究结果时，这些统计上的局限性不应阻碍患者和医生开始运动，并逐步增加运动强度和持续时间。这篇叙述性综述总结了目前关于KT后身体活动不足的有害影响的知识。同时也概述了规律体育锻炼的益处。
