Abstract P282: Cross-sectional Relationship Between Physical Activity and Cardiovascular Risk Factors in Kidney Transplant Patients: A Baseline Examination of the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial

Abstract

Introduction: Data characterizing the potential relationship between physical activity and cardiovascular disease (CVD) risk factors in kidney transplant recipients (KTRs) are limited in the published literature. Accordingly, we sought to: (1) describe the levels of physical activity (PA) in KTRs; and (2) analyze the associations between PA levels and CVD risk factors in KTRs. We report the largest cross-sectional study of PA levels and CVD risk factors in KTRs to date. Methods: Baseline data from the large multiethnic, multicenter trial (FAVORIT) were examined with n = 4034 participants (37% female; mean age 51.9 ± 9.4 years; 75% White; 97% with stage 2T-4T Chronic Kidney Disease; 20% with prevalent CVD). PA was categorized in tertiles (low, moderate, high) derived from a modified PA summary score from the Yale Physical Activity Survey (YPAS). CVD risk factors were examined across levels of PA by ANOVA, Kruskal-Wallis rank test and hierarchical multiple regression modeling. Results: Collectively, participants were less active (mean YPAS 39.9 ± 20.6) compared to similar-aged rheumatoid arthritis (48 ± 21) and osteoarthritis (51 ± 20) samples from other studies. Participants in the “high” PA tertile reported more vigorous PA and walking, compared to participants in moderate and low tertiles (both p < .001). No differences were observed for daily household, occupational or sedentary activities (i.e., standing, sitting, moving about) across PA tertiles. More participants in the “low” PA tertile were overweight/obese and had a history of prevalent diabetes and/or CVD, compared with more active participants (all p < .001). Hierarchical multiple regression revealed that lower age ( p = .002), having a cadaveric donor source ( p = .006), shorter transplant vintage ( p = .025), lower pulse pressure ( p < .001) and no history of diabetes ( p < .001) were significantly associated with higher PA scores. Conclusion: KTR participants appear to be less active than samples of other chronically ill participants. In our data, lower levels of PA were positively associated with the presence of most CVD risk factors in the KTR population. Furthermore, higher PA levels were associated with younger age and variables associated with more positive KTR outcomes. Future longitudinal analyses of this unique KTR cohort will examine whether higher PA levels are associated with reduced risk for the development of hard, centrally-adjudicated CVD outcomes.