Kidney Week

Abstract: TH-PO736

Effect of a Lifestyle Intervention on Sleep and Fatigue in Kidney Transplant Recipients: A Predefined Analysis of the Active Care after Transplantation (ACT) Randomized Clinical Trial

Session Information

• Transplantation: Clinical - 1
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Knobbe, Tim J., Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Tim J. Knobbe, MD

• Kremer, Daan, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Daan Kremer, MD

• Bemelman, Frederike J., Amsterdam Universitair Medische Centra, Amsterdam, Noord-Holland, Netherlands

Frederike J. Bemelman, MD, PhD

• Berger, Stefan P., Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Stefan P. Berger, MD, PhD

• Navis, Gerjan, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Gerjan Navis, MD, PhD

• Bakker, Stephan J.L., Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Stephan J.L. Bakker, MD, PhD

• Corpeleijn, Eva, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Eva Corpeleijn, PhD

Background

Improving lifestyle may be a promising target to improve sleep quality and reduce fatigue among kidney transplant recipients (KTR). We assessed whether a lifestyle intervention, proven to enhance physical functioning, improves sleep and reduces fatigue among KTR.

Methods

We performed a predefined analysis of the Dutch multicenter randomized controlled Active Care after Transplantation (ACT) study (NCT01047410). KTR were randomized into exercise intervention, exercise + diet intervention, or usual care. Exercise intervention included three months supervised exercise with 15 months lifestyle coaching. For the exercise + diet group, this was supplemented with 15 months dietary counselling. Sleep and fatigue were assessed by KDQOL-SF and CIS20R questionnaires. Multilevel general linear mixed model analyses were performed.

Results

We included 146 KTR (36% female, mean age 54±13 years); 57 received exercise intervention, 45 exercise + diet intervention and 44 usual care. At 15 months, both arms showed no statistically significant effect on sleep quality (Figure 1a), with a mean difference in estimated marginal means (EMM) from baseline, compared with control, of +1.7 (95%CI -2.8, +6.2) for the exercise intervention group (P=0.47) and +4.0 (95%CI -0.9, +8.8) for the exercise + diet group (P=0.11). Regarding fatigue severity, no statistically significant effect was observed at 15-months (Figure 1b), with a mean difference in EMM from baseline, compared to the control, of -1.4 (95%CI -7.0, +4.2) for the exercise intervention group (P=0.62) and -0.2 (95%CI -6.2, +5.8) for the exercise + diet intervention group (P=0.94).

Conclusion

Although the lifestyle intervention had previously been shown to improve physical functioning, there was neither a significant treatment effect on sleep nor on fatigue. Improving lifestyle – important as it may be – may not be a panacea for KTR. Addressing sleep and fatigue in this population requires a specific, dedicated approach.

Funding

• Clinical Revenue Support