Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients

doi:10.5500/wjt.v8.i1.13

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World Journal of Transplantation

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2220-3230

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Clinical Trials Study

World J Transplant. Feb 24, 2018; 8(1): 13-22
Published online Feb 24, 2018. doi: 10.5500/wjt.v8.i1.13

Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients

Giulio Sergio Roi, Giovanni Mosconi, Valentina Totti, Maria Laura Angelini, Erica Brugin, Patrizio Sarto, Laura Merlo, Sergio Sgarzi, Michele Stancari, Paola Todeschini, Gaetano La Manna, Andrea Ermolao, Ferdinando Tripi, Lucia Andreoli, Gianluigi Sella, Alberto Anedda, Laura Stefani, Giorgio Galanti, Rocco Di Michele, Franco Merni, Manuela Trerotola, Daniela Storani, Alessandro Nanni Costa

Giulio Sergio Roi, Department of Education and Research, Isokinetic Medical Group, Bologna 40123, Italy

Giovanni Mosconi, Maria Laura Angelini, Department of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì 47121, Italy

Valentina Totti, Rocco Di Michele, Franco Merni, Department of Biomedical & Neuromotor Sciences, University of Bologna, Bologna 40121, Italy

Valentina Totti, Associazione Nazionale Emodializzati, Dialisi e Trapianto, Milano 20121, Italy

Erica Brugin, Department of Cardiovascular, Sports Medicine, Noale 30033, Italy

Patrizio Sarto, Laura Merlo, Sports Medicine, ULSS Company 9, Treviso 31100, Italy

Sergio Sgarzi, Michele Stancari, Sports Medicine, Regional Hospital of Bologna, Bologna 40121, Italy

Paola Todeschini, Gaetano La Manna, Department of Nephrology and Dialysis, S. Orsola Hospital, Bologna 40121, Italy

Andrea Ermolao, Sports Medicine Unit DIMED, Department of Medicine, University of Padua, Padua 35100, Italy

Ferdinando Tripi, Lucia Andreoli, Sports Medicine, Regional Hospital of Modena, Modena 41100, Italy

Gianluigi Sella, Sports Medicine, Regional Hospital of Ravenna, Ravenna 48121, Italy

Alberto Anedda, Sports Medicine, Regional Hospital of Parma, Parma 43121, Italy

Laura Stefani, Giorgio Galanti, Department of Experimental and Clinical Medicine, School of Sports Medicine, University of Florence, Sports Medicine Centre, Florence 50100, Italy

Manuela Trerotola, Daniela Storani, Alessandro Nanni Costa, Italian National Transplant Centre, Rome 00161, Italy

Author contributions: Roi GS and Mosconi G have participated in research design, drafting the paper, performance of the research and critical revision of the paper; Totti V and Angelini ML has participated in drafting the paper, performance of the research and critical revision of the paper; Brugin E, Sarto P, Merlo L, Sgarzi S, Stancari M, Todeschini P, La Manna G, Ermolao A, Capone S, Tripi F, Andreoli L, Sella G, Anedda A, Stefani L, Galanti G and Trerotola M have participated in the performance of the research and data collection; Di Michele R and Merni F have participated in drafting the paper, data analysis and statistics; Nanni Costa A has participated in research design and in the performance of the research.

Institutional review board statement: 118/2010/O/Sper approved 20-07-2010.

Clinical trial registration statement: This study is registered at http://www.isrctn.com/ISRCTN66295470. The registration identification number is ISRCTN66295470.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: Dr. Nanni Costa has nothing to disclose.

Data sharing statement: No additional data are available.

Correspondence to: Alessandro Nanni Costa, MD, Doctor, Italian National Transplant Centre, Istituto Superiore di Sanità, Viale Regina Elena 299, Roma 00161, Italy. daniela.storani@iss.it

Telephone: +39-06-49904040 Fax: +39-06-49904101

Received: October 31, 2017
Peer-review started: November 1, 2017
First decision: November 30, 2017
Revised: December 6, 2017
Accepted: December 28, 2017
Article in press: December 28, 2017
Published online: February 24, 2018
Processing time: 115 Days and 18.3 Hours

ARTICLE HIGHLIGHTS

Research background

Kidney transplant recipients (KTRs) are characterised by long term clinical complications and high risk of cardiovascular disease. After transplantation, physical activity is considered a key element in the prevention and management of chronic diseases, however the majority of KTRs maintain a sedentary lifestyle, often associated with an increase of body fat and weight gain. Whether exercise can positively affect outcomes in KTRs has only been addressed in few studies, with a small number of subjects and with different types, intensity and durations of interventions lasting almost always not more than six mo. Furthermore, few studies have investigated the effect of a combined aerobic and resistance training, and the effect of these protocols on kidney function is rather unknown. In this paper, we present some clinical and fitness outcomes of a 12-mo study conducted on KTRs, with the aim to evaluate the potential effects of supervised exercise combining aerobic and resistance training.

Research frontiers

Developing a supervised exercise protocol for KTRs is a useful and safe non-pharmacologic contribution to usual after-transplant treatments, which can improve the physiological variables related to physical fitness and cardiovascular risks without consequences on renal function. Further studies with longer follow-up and larger populations are necessary to understand the strategies that will improve adherence to training programmes, control costs and lead to steady and durable lifestyle changes in KTRs.

Innovations and breakthroughs

Selected KTRs can safely perform training protocols lasting 12 mo, with association of aerobic and resistance exercises.

Applications

The collaboration between transplant centres, sports medicine centres and exercise facilities is effective to prevent the low adherence to suggested and/or prescribed physical activity.

Terminology

Oxygen uptake (V’O₂) at the highest tolerated workload was referred to as V’O₂ peak (mLO₂/kg per minute).