Aerobic or Resistance Training and Pulse Wave Velocity in Kidney Transplant Recipients: A 12-Week Pilot Randomized Controlled Trial (the Exercise in Renal Transplant [ExeRT] Trial)

Greenwood, Sharlene; Koufaki, Pelagia; Mercer, Thomas H.; Rush, Robert; O’Connor, Ellen; Tuffnell, Rachel; Lindup, Herolin; Haggis, Lynda; Dew, Tracy; Abdulnassir, Lyndsey; Nugent, Eilish; Goldsmith, David; Macdougall, Iain C.

doi:10.1053/j.ajkd.2015.06.016

Cited by 81 publications

(126 citation statements)

References 45 publications

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“…The average age of transplant patients was quite low (40±13 in the exercise arm), and no frailty screening was done at recruitment. A small UK pilot trial 44 (N=13 in exercise arm) recruited older patients within 1 year of transplant and tested the effects of 12 weeks of supervised structured exercise classes twice per week. They reported a statistically non-significant trend toward an improvement in peak VO 2 attributable to aerobic training that persisted for 6 months beyond the intervention end date.…”

Section: Frailty and Posttransplant Managementmentioning

confidence: 99%

Implications of Frailty for Peritransplant Outcomes in Kidney Transplant Recipients

et al. 2019

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Purpose of Review Research over the past few decades points to the importance of frailty, or the lack of physiologic reserve, in the natural history of chronic diseases and in modifying the impact of potential interventions. End-stage kidney disease (ESKD) and the intervention of kidney transplantation are no exception. We review the recent epidemiologic and cohort-based evidence on the association between frailty and kidney transplant outcomes and provide a framework of questions with which to approach future research endeavors and clinical practice. Recent Findings Frailty in kidney transplant candidates can be measured in numerous ways, including descriptive phenotype, description scores, functional testing, and surrogate measures. Regardless of the metric, the presence of frailty is strongly associated with inferior pre- and posttransplant outcomes compared to the absence of frailty. However, some frail patients with ESKD can benefit from transplant over chronic dialysis. Evidence-based approaches for identifying frail ESKD patients who can benefit from transplant over dialysis, with acceptable posttransplant outcomes, are lacking. Interventional trials to improve frailty and physical function before transplant (prehabilitation) and after transplant (rehabilitation) are also lacking. Conclusion Frailty is increasingly recognized as highly relevant to peritransplant outcomes, but more work is needed to: 1) tailor management to the unique needs of frail patients, both pre- and posttransplant; 2) define phenotypes of frail patients who are expected to benefit from transplant over dialysis; and 3) develop interventions to reverse frailty, both pre- and post-transplant.

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Section: Frailty and Posttransplant Managementmentioning

confidence: 99%

Implications of Frailty for Peritransplant Outcomes in Kidney Transplant Recipients

et al. 2019

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“…; Painter & Roshanravan ; Heiwe & Jacobson ; Greenwood et al . ), functional ability (Greenwood et al . ; Painter & Roshanravan ), self‐reported anxiety (Greenwood et al .…”

Section: Introductionmentioning

confidence: 99%

Test–Retest Reliability for Physical Function Measures in Patients with Chronic Kidney Disease

Hadjiioannou

Wong

Lindup

et al. 2019

Journal of Renal Care

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SUMMARY Background It is important to determine relative and absolute reliability values in outcome measures that are used in clinical practice so as to discriminate between true changes following exercise interventions for patients with chronic kidney disease (CKD). Objective The study aimed to assess test–retest reliability of the incremental shuttle walk test (ISWT), sit‐to‐stand transfers in 60 seconds (STS‐60), timed up and go (TUAG), Duke's activity status index (DASI) and hospital anxiety and depression scale (HAD) in patients with CKD. Study Design This study was a pragmatic non‐randomised controlled trial. Methods Forty people attended two study visits within a 16‐day window involving the ISWT, STS‐60, TUAG, DASI and HAD tests. Relative reliability was assessed using intraclass correlation coefficient (ICC) and absolute reliability using the standard error of measurement (SEM) and minimal detectable change (MDC). Results Good test–retest reliability was found for the entire sample size across all outcome measures, with TUAG having the highest (ICC = 0.96) and HAD the lowest (ICC = 0.71). The MDC scores at 90% confidence interval (CI) were: 79.6 m for the ISWT, 2.9 seconds for the TUAG, 7.0 repetitions for the STS‐60, 8.4 for the DASI, 3.8 for the anxiety HAD subscale and 4.4 for the depression HAD subscale. Conclusions This study demonstrated good test–retest reliability for all outcome measures across the CKD trajectory but caution needs to be taken when interpreting the findings for each CKD sub‐group separately. The MDC scores at 90% CI can support therapists in determining a true improvement in CKD patients' physical or mental performance.

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“…Therefore, no study to date has demonstrated that intradialytic PRT can improve arterial stiffness in patients with dialysis‐dependent ESRD. However, improvements in arterial stiffness secondary to PRT have been noted in two studies enrolling renal transplant recipients . These findings could be attributed to the longer duration or higher intensity of PRT applied in these studies.…”

Section: Discussionmentioning

confidence: 89%

“…However, improvements in arterial stiffness secondary to PRT have been noted in two studies enrolling renal transplant recipients . These findings could be attributed to the longer duration or higher intensity of PRT applied in these studies. Future research is required to determine if PRT can adapt arterial stiffness in dialysis patients and the dosages required to elicit the effect.…”

Section: Discussionmentioning

confidence: 89%

Effect of intradialytic resistance training on pulse wave velocity and associated cardiovascular disease biomarkers in end stage renal disease

et al. 2018

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Aerobic or Resistance Training and Pulse Wave Velocity in Kidney Transplant Recipients: A 12-Week Pilot Randomized Controlled Trial (the Exercise in Renal Transplant [ExeRT] Trial)

Cited by 81 publications

References 45 publications

Implications of Frailty for Peritransplant Outcomes in Kidney Transplant Recipients

Implications of Frailty for Peritransplant Outcomes in Kidney Transplant Recipients

Test–Retest Reliability for Physical Function Measures in Patients with Chronic Kidney Disease

Effect of intradialytic resistance training on pulse wave velocity and associated cardiovascular disease biomarkers in end stage renal disease

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