Physical Activity and the Development of Post-Transplant Diabetes Mellitus, and Cardiovascular- and All-Cause Mortality in Renal Transplant Recipients

Abstract

(1) Background: Little is currently known about the health impacts of daily-life moderate-to-vigorous physical activity (MVPA) in relation to the development of post-transplant diabetes mellitus (PTDM) and the long-term survival of renal transplant recipients (RTRs). (2) Methods: We analyzed self-reported data on MVPA within non-occupational and occupational domains, estimated with the SQUASH questionnaire, from a prospective cohort study of RTRs (n = 650) with a functioning graft exceeding 1 year. PTDM diagnoses were based on plasma glucose levels (≥126 mg/dL), HbA1c (≥6.5%), and the use of antidiabetic medication. Mortality data were retrieved from patient files up to the end of September 2015. (3) Results: During a median follow-up period of 5.3 years, 50 patients (10%) developed PTDM and 129 (19.8%) died. Of these deaths, 53 (8.9%) were caused by cardiovascular disease. Cox regression analyses showed that higher MVPA levels among patients were associated with a lower risk of PTDM (hazard ratio (HR); 95% confidence interval (95%CI) = 0.49; 0.25–0.96, p = 0.04), cardiovascular- (0.34; 0.15–0.77, p = 0.01), and all-cause mortality (0.37; 0.24–0.58, p < 0.001) compared with No-MVPA patients, independently of age, sex, and kidney function parameters. Associations of MVPA with cardiovascular and all-cause mortality remained significant and materially unchanged following further adjustments made for transplant characteristics, lifestyle factors, metabolic parameters, medication use, and creatinine excretion (muscle mass). However, the association between MVPA and PTDM was no longer significant after we adjusted for metabolic confounders and glucose levels. (4) Conclusion: Higher MVPA levels are associated with long-term health outcomes in RTRs.

Physical Inactivity: A Modifiable Risk Factor for Morbidity and Mortality in Kidney Transplantation

“…A small trial with 20 participants has shown that in a 12-month course of 3 days per week, resistance or aerobic training may lead to a significant increase in mean estimated glomerular filtration rate (+7.8 ± 3.0 mL/min/1.73 m 2 per year; p = 0.02) in comparison to no intervention [ 68 ]. In another study, regular exercise was associated with a reduced incidence of new-onset diabetes mellitus after transplantation [ 69 ].…”

Influence of Officially Ordered Restrictions during the First Wave of COVID-19 Pandemic on Physical Activity and Quality of Life in Patients after Kidney Transplantation in a Telemedicine Based Aftercare Program—A KTx360° Sub Study

“…The guideline for the care of KTx recipients recommends adopting a healthy lifestyle with regular physical activity (PA) [3]. It has been shown that PA post KTx can reduce the risk for developing diabetes or cardiovascular diseases, and even mortality [4]. Effectivity of exercise programs in increasing performance has been shown in a recent review including a total of 24 studies [5].…”

Effect of Regular Physical Activity and Lifestyle Changes on Insulin Resistance in Patients after Kidney Transplantation

“…In 2011, Zelle et al in a prospective study on a sample of 540 recipients after KT, they con rmed a strong independent correlation between low physical activity and cardiovascular and overall mortality (22). Recently, Byambasukh et al published work in which recipients performing moderate to high intensity physical activity showed signi cantly lower cardiovascular and overall mortality compared to recipients with a sedentary lifestyle regardless of age, gender, and graft function (23).…”