Exercise therapy post-transplant shows benefits with no adverse impact on kidney function
An exercise therapy program initiated shortly after kidney transplantation led to improved measures of physical performance without adversely impacting patients’ kidney function, according to results of a study from Japan.
“Although [kidney transplantation] KT can improve life prognosis and quality of life (QOL), physical performance and physical activity levels of patients after KT remain lower than that of healthy individuals,” Shohei Yamamoto, MSc, of the department of rehabilitation sciences at Kitasato University Graduate School of Medical Sciences in Japan, and colleagues wrote.
According to the researchers, poor physical performance and activity levels can increase risk for frailty, which is associated with delayed graft function, prolonged hospital length of stay, early hospital readmission and higher rates of mortality.
“Therefore,” they suggested, “it is necessary to initiate a disease management approach aimed at improvement or prevention of frailty from the early phase after KT, beginning as early as possible.”
Yamamoto and colleagues identified an exercise program as one such approach, assigning 10 patients to an intervention group (including exercise plus usual care) and 14 patients to usual care alone. The exercise program consisted of supervised aerobic training and physical activity instruction in the hospital and at home by a physical therapist. The program began on day 6 following kidney transplantation and continued for 2 months, with researchers assessing 6-minute walking distance, isometric knee extensor strength, gait speed, physical activity and quality of life.
At 2 months after kidney transplantation, researchers observed that mean 6-minute walking distance was significantly higher than that at the baseline in the exercise group but not in the control group (within-group difference of +45.4 m for those in exercise group vs. -0.9 for control). Isometric knee extensor strength (expressed as a percentage of body weight [%BW]) was also significantly higher in the exercise group but not in the control group (within-group mean differences: +6.2% BW and -2.4% BW, respectively).
Regarding kidney function, no patients in either intervention or control group experienced graft loss at 2 months and the eGFR was similar between the groups.
The researchers noted the program appeared to be safe, as there were no reported adverse events, musculoskeletal injuries, hypoglycemic episodes, cardiovascular events or infectious diseases as a result of the exercise interventions.
“These results further support the utility of exercise therapy for patients with KT and demonstrate the feasibility of exercise therapy beginning within the hospitalization period after KT,” they wrote.