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Kidney transplant patients urged to keep fit to survive

Exercise may help kidney transplant patients live longer with low physical activity increasing these patients' likelihood of dying early.

Kidney transplant patients urged to keep fit to survive

Exercise may help kidney transplant patients live longer with low physical activity increasing these patients' likelihood of dying early.

Inactive people in general face higher risks of developing cardiovascular disease and of dying prematurely. Individuals with chronic kidney disease - particularly those on dialysis - tend to get little exercise, but most increase their activity levels modestly after receiving a kidney transplant. Until now, no one has examined whether low physical activity levels in kidney transplant recipients is associated with higher risk of dying prematurely from heart-related or other causes. Maintaining heart health is particularly important for these individuals, as kidney transplant recipients have a 4 to 6-fold increased risk of dying from cardiovascular causes than individuals in the general population.

Dutch researchers assessed the health of 540 kidney transplant recipients between 2001 and 2003 and monitored their physical activity levels through questionnaires until 2007. It was found that 260 (48 percent) of the patients did not meet guidelines for minimum requirements of physical activity and 79 (14.6 percent) were completely inactive. During the study period, there were 81 deaths among the patients, including 37 heart-related deaths. The death rate was higher among those who participated in lower levels of physical activity.

Specifically, cardiovascular deaths occurred in 11.7 percent of inactive patients, 7.2 percent of moderately active patients and 1.7 percent of active patients. The rates of death from any cause were 24.4 percent in inactive patients, 15 percent in moderately active patients and 5.6 percent in active patients.

Even though the investigators acknowledged that in general, sicker people are less likely to exercise and more likely to die;  the association between low levels of physical activity and high risk of death was not substantially affected when  adjusted for factors such as heart health, kidney function, muscle mass, diabetes and smoking. To determine whether increased physical activity levels may improve the health and prolong the lives of transplant recipients, a further study is planned in which kidney transplant recipients will undergo a supervised exercise program and receive individual counseling to promote physical activity and a healthy diet.
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