Longitudinal measurement of physical activity following kidney transplantation

Abstract

The purpose of this longitudinal observational study was to (i) examine the change of daily physical activity in 28 adult kidney transplant recipients over the first 12 months following transplantation; and (ii) to examine the change in metabolic characteristics and renal function. Accelerometer-based daily physical activity and metabolic- and clinical characteristics were measured at six wk (T1), three months (T2), six months (T3) and 12 months (T4) following transplantation. Linear mixed effect analyses showed an increase in steps/d (T1 = 6326 ± 2906; T4 = 7562 ± 3785; F = 3.52; p = 0.02), but one yr after transplantation only 25% achieved the recommended 10 000 steps/d. There was no significant increase in minutes per day spent on moderate-to-vigorous intensity physical activity (T1 = 80.4 ± 63.6; T4 = 93.2 ± 55.1; F = 1.71; p = 0.17). Body mass index increased over time (T1 = 25.4 ± 3.2; T4 = 27.2 ± 3.8; F = 12.62; p < 0.001), mainly due to an increase in fat percentage (T1 = 30.3 ± 8.0; T4 = 34.0 ± 7.9; F = 14.63; p < 0.001). There was no significant change in renal function (F = 0.17; p = 0.92). Although the recipients increased physical activity, the majority did not meet the recommended levels of physical activity after one yr. In addition to the weight gain, this may result in negative health consequences. Therefore, it is important to develop strategies to support kidney transplant recipients to comply with healthy lifestyle recommendations, including regular physical activity.

Muscle mass determined from urinary creatinine excretion rate, and muscle performance in renal transplant recipients

“…Such treatment has been shown to increase muscle protein degradation and induce muscle atrophy. 31 As the cumulative prednisolone dose did not differ across sex-stratified tertiles of CER, it cannot explain the differences in CER between RTR, but on population level, it could contribute to the difference between RTR and healthy controls. Finally, RTR can be subjected to rejection episodes, to intercurrent diseases, do often exhibit a chronic immune response to the transplant, do often endure the inflammatory aspects of chronic atherosclerosis, and usually suffer from suboptimal kidney function, all of which can contribute to chronic low-grade inflammation and protein-energy wasting.…”

“…In many RTR, the immunosuppressive regimen for prevention of allograft rejection includes chronic treatment with glucocorticoids. Such treatment has been shown to increase muscle protein degradation and induce muscle atrophy . As the cumulative prednisolone dose did not differ across sex‐stratified tertiles of CER, it cannot explain the differences in CER between RTR, but on population level, it could contribute to the difference between RTR and healthy controls.…”

Goal disturbance changes pre/post‐renal transplantation are related to changes in distress

“…Renal transplantation has been related in longitudinal research to significant improvements in patients’ physical functioning and overall quality of life (Dew et al ., ; Dontje et al ., ; Franke et al ., ; Jofre, López‐Gómez, Moreno, Sanz‐Guajardo, & Valderrábano, ; von der Lippe et al ., ; Tonelli et al ., ). Despite inconsistent findings across different studies (von der Lippe et al ., ), psychological functioning generally was also found to improve after renal transplantation (Griva, Davenport, Harrison, & Newman, ; Joshi, Almeida, & Almeida, ; Kostro et al ., ; Landreneau, Lee, & Landreneau, ; Tavallaii & Lankarani, ).…”

Benefit finding in renal transplantation and its association with psychological and clinical correlates: A prospective study

“…Transplantation is associated with a better quality of life and higher life expectancy compared to dialysis (Landreneau, Lee, & Landreneau, 2010;Li et al, 2017;Tonelli et al, 2011). However, transplantation has consistently been associated with improvements in physical functioning, well-being, and overall quality of life (Dontje et al, 2014;Tavallaii & Lankarani, 2005;Tonelli et al, 2011;von der Lippe et al, 2014). In fact, levels of well-being and quality of life after transplantation remain lower compared to that of the general population (Karam et al, 2003;Weber et al, 2014).…”

“…In fact, levels of well-being and quality of life after transplantation remain lower compared to that of the general population (Karam et al, 2003;Weber et al, 2014). However, transplantation has consistently been associated with improvements in physical functioning, well-being, and overall quality of life (Dontje et al, 2014;Tavallaii & Lankarani, 2005;Tonelli et al, 2011;von der Lippe et al, 2014). Moreover, qualitative research has shown that kidney recipients perceive the transplant as a chance to live a new and better life (Buldukoglu et al, 2005;Schipper et al, 2014).…”