Effects of exercise training on coronary heart disease risk factors in renal transplant recipients

Painter, Patricia; Hector, L. L.; Ray, K. M.; Lynes, L. K.; Paul, Steven M.; Dodd, Marylin; Tomlanovich, S.; Ascher, Nancy L.

doi:10.1016/s0272-6386(03)00673-5

Cited by 85 publications

(68 citation statements)

References 34 publications

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“…Those who are more physically active have a reduced CV risk [111] and exercise programmes designed for RTRs have been shown to improve a number of physiological and psychological parameters [112,113] . However, blood pressure has been measured in several studies and there are no overall significant effects of exercise [114,115] . Many patients are taking various classes of antihypertensive medications and exercise does not seem to interact with these either [112] .…”

Section: Lifestyle Factorsmentioning

confidence: 99%

“…A major contributor to atherosclerotic risk, blood lipid levels, have been analysed in RTRs. There is no clear consensus as to whether exercise has a beneficial effect on cholesterol or not as some studies show an improvement [116] and others do not [115,117] . Markers of prediabetes in nondiabetics or of diabetic control again produce conflicting results with differences between glucose levels not necessarily reflecting activity levels [117] .…”

Section: Lifestyle Factorsmentioning

confidence: 99%

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Cardiovascular risk factors following renal transplant

Neale

Smith

2015

WJT

117

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Kidney transplantation is the gold-standard treatment for many patients with end-stage renal disease. Renal transplant recipients (RTRs) remain at an increased risk of fatal and non-fatal cardiovascular (CV) events compared to the general population, although rates are lower than those patients on maintenance haemodialysis. Death with a functioning graft is most commonly due to cardiovascular disease (CVD) and therefore this remains an important therapeutic target to prevent graft failure. Conventional CV risk factors such as diabetes, hypertension and renal dysfunction remain a major influence on CVD in RTRs. However it is now recognised that the morbidity and mortality from CVD are not entirely accounted for by these traditional risk-factors. Immunosuppression medications exert a deleterious effect on many of these well-recognised contributors to CVD and are known to exacerbate the probability of developing diabetes, graft dysfunction and hypertension which can all lead on to CVD. Nontraditional CV risk factors such as inflammation and anaemia have been strongly linked to increased CV events in RTRs and should be considered alongside those which are classified as conventional. This review summarises what is known about risk-factors for CVD in RTRs and how, through identification of those which are modifiable, outcomes can be improved. The overall CV risk in RTRs is likely to be multifactorial and a complex interaction between the multiple traditional and non-traditional factors; further studies are required to determine how these may be modified to enhance survival and quality of life in this unique population. Core tip: Cardiovascular disease (CVD) is the leading cause of death and disability in patients following a renal transplant. Identification of risk factors for CVD and strategies for their improvement are required in order to prevent graft failure in this complex patient

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Section: Lifestyle Factorsmentioning

confidence: 99%

Section: Lifestyle Factorsmentioning

confidence: 99%

Cardiovascular risk factors following renal transplant

Neale

Smith

2015

WJT

117

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“…As such, these individuals need special care when prescribing exercise and should be under close supervision. Cardiovascular complications are also common in individuals with nephropathy, although little evidence exists that exercise triggers any adverse events (Moore et al 1998;Painter 1988;Painter et al 2002Painter et al , 2003. As special care may be needed in these individuals with advanced disease, including erythropoietin administration (Moore al.…”

Section: Kidney Diseasementioning

confidence: 99%

Evidence-based risk assessment and recommendations for physical activity clearance: diabetes mellitus and related comorbidities¹This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer review process.

Riddell

Burr

2011

Appl. Physiol. Nutr. Metab.

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Physical activity (PA) is one of the most powerful treatment options for persons with prediabetes or diabetes. However, some elevation in risk occurs with increased PA, at least initially, and certain precautions need to be made to lower these risks, particularly if these persons are unaccustomed to exercise. We conducted a standardized search of all adverse events associated with increased PA in persons with prediabetes or diabetes (type 1 or type 2) and provided evidencebased guidelines on PA screening in these apparently high-risk individuals. A systematic literature review was performed of all studies reporting on adverse events in persons with prediabetes or diabetes. Studies included were from all designs (retrospective and prospective including randomized controlled trials) and were assessed according to evaluation criteria adapted by a consensus panel. A total of 47 studies, involving >8000 individuals, were deemed eligible. A number of these studies identified a range of mild to severe acute risks with exercise (musculoskeletal injury, hypoglycemia, foot ulceration, proliferative retinopathy, hypotension, sudden death) but the overall prevalence was low. Based on several randomized controlled trials and prospective studies in which prescribed exercise was performed at a wide range of intensities, it appears that increased PA is a relatively safe procedure with no evidence of a loss of life. Based on our assessment of the available literature, we provide a new PA risk algorithm for persons with prediabetes and diabetes and comment on the role of the patient, the qualified exercise professional, and the patient's physician in the risk screening process.Key words: exercise, diabetes mellitus, prediabetes, adverse events, Par-Q.Résumé : L'activité physique (PA) est un des meilleurs traitements à l'intention des personnes prédiabétiques et diabéti-ques. Toutefois, avec l'intensification de la pratique de l'activité physique vient une augmentation du risque, du moins au début, et il est donc indiqué de prendre des précautions pour diminuer ce risque particulièrement chez les personnes non accoutumées à l'effort physique. Nous avons réalisé une recherche systématique de tous les événements indésirables se présen-tant avec l'intensification de la PA chez des personnes prédiabétiques et diabétiques (type 1 et type 2) et nous présentons des directives basées sur des données probantes pour le dépistage des patients apparemment à haut risque en matière de PA. On effectue une analyse documentaire systématique de toutes les études présentant des événements indésirables s'étant manifestés chez des personnes prédiabétiques et diabétiques. Les études incluent tous les devis expérimentaux (rétrospectifs et prospectifs y compris les essais cliniques aléatoires (RCTs)); on évalue ces études en fonction des critères adaptés par consensus d'experts. Au total, 47 études comprenant plus de 8000 personnes sont retenues. Un certain nombre d'études identifient des risques associés à PA allant de faibles à graves (blessu...

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“…Physical activity also may delay development of atherosclerosis, which is the primary cause of death in kidney transplant recipients. 13,14 Extensive research also has been performed about the relation between physical activity and cancer. Numerous reviews of epidemiologic and randomized controlled trials have confirmed an inverse relation between physical activity and the incidence of cancer.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Objectives: Physical activity has an effect on longterm recovery after major surgical operations including liver transplant. Seven-Day Physical Activity Recall Questionnaire is a semistructured survey that assesses an individual's time spent in physical activity, strength, and flexibility activities during the 7 days prior to the interview. In this study we applied the Seven-Day Physical Activity Recall Questionnaire in patients who underwent liver transplant in our center. Materials and Methods:We surveyed 107 consecutive patients (62 male and 45 female), who were ≥ 6 months after liver transplant. Patients were divided into 3 groups, depending on time after liver transplant: group A (n = 21), 6 to 12 months posttransplant; group B (n = 48), 13 to 36 months posttransplant; and group C (n = 38), > 37 months posttransplant. Relations were analyzed between physical activity and various factors including sex, age at procedure and survey, time after grafting, original diagnosis, and body mass index. Results: Female patients were significantly less active in daily and weekly measurements (981 ± 212 kcal vs 1267 ± 229 kcal; P < .0001) (6864 ± 1484 kcal vs 8866 ± 1607 kcal; P < .0001). There was a negative correlation between physical activity and age at transplant (P = .02) and survey (P = .02). Neither the time after liver transplant nor the original diagnosis before grafting affected physical activity. Conclusions: Female patients, when assessed with Seven-Day Physical Activity Recall Questionnaire, were significantly less physically active than male subjects after liver transplant. Younger patients were more active, but primary diagnosis had no significant effect on physical activity after grafting.

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Effects of exercise training on coronary heart disease risk factors in renal transplant recipients

Cited by 85 publications

References 34 publications

Cardiovascular risk factors following renal transplant

Cardiovascular risk factors following renal transplant

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