Abstract
Renal transplantation is the choice treatment for end-stage renal disease. In spite of transplantation, cardiovascular morbidity and mortality remains high, possibly due to a prolonged sedentary lifestyle prior to transplantation. This study aimed to evaluate the impact of unsupervised intervention in a tailored home-based aerobic resistance exercise program, based on the anthropometric and cardiovascular parameters in a group of renal transplant recipients (RTRs) followed for 12 months. Methods: a group of 21 RTRs (mean age: 46.8 ± 12 years) were enrolled in a combined aerobic and step count unsupervised prescription program. Body composition (BMI, waist circumferences, skin-folds); water distribution (TBW: Total body water; ECW: Extra cellular water; and ICW: Intracellular water) and myocardial function were measured every 6 months for 1 year. The MEDI-LITE score was used to estimate adherence to the Mediterranean diet. Results: Significant reductions in waist circumference (Waist Cir: 89.12 ± 12.8 cm T0; 89.1 ± 12.5 cm T6 (95% CI: 6.3, 5.7); 88.6 ± 11.4 cm T12; (95% CI: 6.7, 4.7) p < 0.01), weight:71.8 ± 14.8 kg T0; 70.6 ± 14.7 kg T6(95% CI:−8, 6); 70.6 ± 14.7 kg T12(95% CI: 6.6, 7) p < 0.05), as well as an improvement of myocardial function, as shown by the significant increase of contractility and change in the GLS % value (−18.3 ± 3.8% at T0 (95% CI:−16.57, 20.0.2)−20.4 ± 3.0% at T6(95% CI:−4, 0.2);−22.9 ± 3.1%T12(95% CI:−3, 4, −1, 6) p < 0.02), were observed. Adherence to the Mediterranean diet was in the normal range. Conclusions: Despite unsupervised intervention, combined moderate physical exercise appears to have a positive effect on the main parameters related to cardiovascular risk factors. The long-term efficacy of this program requires further investigation, particularly for evaluating constant adherence to the home-based physical exercise program.
Highlights
Renal transplantation is the choice treatment for end-stage renal disease [1]
Considering this is a pilot study, the renal transplant recipients (RTRs) were consecutively enrolled at the Sports Medicine Center of the University of Florence, on the basis of their motivation to adhere to the protocol
The literature reports some of the effects of physical exercise in RTR, focusing on arterial blood anemia, glycaemia, or lipedema, and on several aspects of quality of life
Summary
Renal transplantation is the choice treatment for end-stage renal disease [1]. It aims to restore a normal lifestyle and prolong survival. Patients maintain high cardiovascular morbidity and mortality compared to the general population [2]. Due to the use of steroids and immunosuppressive drugs, suboptimal renal function and weight gain are often present in renal transplantation patients [3]. The nutrition in RTR may increase the frequency of infection and accelerate the atherosclerotic process [4]. It has long been observed that a sedentary lifestyle is an important factor influencing the increase in cardiovascular mortality, when associated to arterial hypertension, diabetes, and other cardio-metabolic risk factors, such as dyslipidemia [5]
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