Exercise increases survival rate after kidney transplant

Patients who take a lot of exercise after having had a kidney transplant have a higher life expectancy than patients who do not exercise much. Now that there are far fewer problems with organ rejection and infections in the first year after a kidney transplant, attention has shifted to improving long-term survival rates. Preventing cardiovascular disease is very important, as kidney transplant patients are at high risk of developing this. Researchers at the University Medical Center Groningen have now managed to prove for the first time ever that kidney transplant patients have a higher life expectancy if they exercise more. The results of their research were published in the renowned Clinical Journal of the American Society of Nephrology of March 3, 2011.

A transplant is an important and positive pivotal moment in the life of a kidney patient. Prior to the transplant they have often experienced a prolonged period of impaired renal function and/or were on dialysis. Mental and physical fatigue and the inability to cope with any physical exertion are often-heard complaints during that time.

Until now, little attention has been paid to improving lifestyle after the kidney transplant. Patients often revert to their old eating patterns and physical inactivity and many of them gain a lot of weight after their transplant. Dorien Zelle and her colleagues from the departments of Nephrology and Epidemiology investigated the health of 540 patients who had had a kidney transplant between 2001 and 2003. They used questionnaires to chart how much the patients exercised. According to daily exercise guidelines, 260 patients (48%) did not get enough exercise, while 79 patients (15%) were completely inactive.

Eighty-one of the patients died during the period ending in August 2007 when the study was conducted, 37 of them due to cardiovascular disease. The researchers discovered a connection between the amount of exercise and the chances of dying; death due to cardiovascular disease was 11.7%, 7.2% and 1.7% for the groups that were inactive, moderately active and active, respectively. The same connection with physical exercise could be found for every cause of death.

Based on these results, the UMCG has initiated a new study to investigate the effects after a kidney transplant of lifestyle supervision, healthy nutrition and more exercise. For the research, three groups of 60 patients each will be compared, receiving either standard care, an exercise programme, or a combined nutrition and exercise programme. The UMCG researchers working on this ‘Active Care after a Transplant’ (Actieve Zorg na Transplantatie) project will collaborate closely with the Maastricht project ‘Group Rehabilitation of Kidney Patients’ (Groepsrevalidatie Nierpatiënten). The new research is partially funded by the Dutch Kidney Foundation (Nierstichting).