Kidney Week

Abstract: FR-OR34

Cardiorespiratory Fitness in Kidney Transplant Recipients and the Effects of Home-Based Rehabilitation

Session Information

• Exercise and Kidney Health: From Bench to Smartphone
  October 25, 2024 | Location: Room 4, Convention Center
  Abstract Time: 05:30 PM - 05:40 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Billany, Roseanne E., University of Leicester, Leicester, United Kingdom

Roseanne E. Billany, PhD

• Ford, Ella C., Leeds Beckett University, Leeds, United Kingdom

Ella C. Ford

• Sohansoha, Gurneet Kaur, University of Leicester, Leicester, United Kingdom

Gurneet Kaur Sohansoha

• Burns, Stephanie Elizabeth, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom

Stephanie Elizabeth Burns

• Vadaszy, Noemi, University of Leicester, Leicester, United Kingdom

Noemi Vadaszy, MSc

• Mubaarak, Zahra, University of Leicester, Leicester, United Kingdom

Zahra Mubaarak

• Bishop, Nicolette C., Loughborough University, Loughborough, United Kingdom

Nicolette C. Bishop

• Smith, Alice C., University of Leicester, Leicester, United Kingdom

Alice C. Smith, MSc, PhD

• Graham-Brown, Matthew, University of Leicester, Leicester, United Kingdom

Matthew Graham-Brown, MBChB, PhD

Background

Kidney transplant recipients (KTR) have an increased burden of cardiovascular disease (CVD) and poor cardiorespiratory fitness (CRF) is associated with poorer clinical outcomes; particularly cardiovascular related. The aims of this study were: (1) to compare CRF parameters in KTR and age-sex matched healthy volunteers (HV), (2) explore the CRF related effects of 12-weeks of home-based exercise rehabilitation in KTR.

Methods

30 KTR (14 male; age 61±8 years) and 30 HV (14 male; age 61±7 years) completed a continuous ramp cardiopulmonary exercise test (CPET) to volitional exhaustion. 50 KTR (>1-year post-transplant; 50±14 years; 23 male) were randomised 1:1 to: intervention (INT: a 12-week home-based combined aerobic and resistance exercise programme) or control (CT: guideline-directed care).

Results

KTR had reduced exercise capacity and increased ventilatory response to exercise compared to HV (Fig 1). Relative VO_2peak was 5.29 ±1.35 ml/kg/min lower in KTRs v HV. Post-intervention VO_2peak, after baseline adjustment, was greater in INT v CT (+1.50 ml/kg/min (95%CI: 0.1-2.9; p=.03)) as was max power (+8 W, p<.03) and heart rate (+10 bpm, p<.04). Total number of aerobic exercise session performed was associated with greater change in VO_2peak (R₂=.252, p=.04).

Conclusion

CRF is impaired in KTR compared to age-sex matched HV. This may relate to low levels of physical activity, but could imply underlying cardiovascular dysfunction. Home-based rehabilitation significantly improved CRF. These results indicate the need to prioritise the development and implementation of structured exercise and educational programmes for KTR as part of routine care.