Physical activity and exercise performance in patients after kidney transplantation - Data from the prospective...

The effects of regular and suitable physical activity after organ transplantation are understudied and not conclusive.

Multicenter, prospective observational study.

The online-supported post-transplant care program KTx360° included central coordination of patient visits, regular outpatient consultations, and video or face-to-face psychosomatic and physical activity counseling. 676 adult patients (41 % women, 54 yrs [IQR 43-63], time since transplantation: 3.0 yrs [IQR 0.3-6.8]) who participated at the guided physical activity part of the program were analyzed for physical activity, cardiovascular response during submaximal exercise and functional evaluation over 6 and 12 months.

At baseline, exercise capacity was below normative values (73.0 % [IQR 58.8-88.2]) and was associated with body mass index (rho: -0.41), physical activity (rho: 0.38) and time since transplantation (rho: 0.12) (all p < 0.01). Questionnaire-assessed physical activity increased from baseline (24.9 ± 20.2 MET-hrs/wk) to month 6 (30.6 ± 25.3 MET-hrs/wk) and to month 12 (29.5 ± 23.8 MET-hrs/wk) (p < 0.01). Heart rate and blood pressure during submaximal exercise testing significantly lowered after 12 months. Lower body strength (1-min sit-to-stand test) was below normative values (68.1 % (IQR 57.3-79.6)) and increased from baseline (26 reps [IQR 22-31]) to month 6 (30 reps [IQR 25-36]) and further to month 12 (32 reps [IQR 26-38]) (p < 0.01).

A multimodal follow-up care program promoting physical activity improved markers of endurance, cardiovascular health, and muscular strength in kidney transplant recipients. Given the reduced physical capabilities in these patients, such intervention could help them to better cope with the tasks of everyday life and improve graft survival.