Renal transplantation
Candidate
Factors Associated With Peak Oxygen Uptake in Hemodialysis Patients Awaiting Renal Transplantation

https://doi.org/10.1016/j.transproceed.2007.02.013Get rights and content

Abstract

The preoperative evaluation of pulmonary function is important in renal transplantation candidates. Exercise capacity determined by peak oxygen uptake (peak Vo2) is a predictor of perioperative mortality and survival. The aim of this study was to determine the factors associated with the peak Vo2 among renal transplantation candidates undergoing hemodialysis.

Thirty patients with chronic renal failure including 14 women and 16 men of mean age 40.2 ± 10.3 years had a mean duration of dialysis of 133.1 ± 63.3 months and were awaiting renal transplantation. None of the patients had signs or symptoms of active infection or inflammation. Each patient underwent pulmonary function and symptom-limited cardiopulmonary exercise tests. Despite the absence of clinically evident inflammation, a malnutrition inflammation score was calculated for each patient to assess comorbid conditions and the risk of atherosclerosis. Demographic and laboratory parameters were obtained from hospital records.

The peak Vo2 was positively correlated with the serum triglyceride level and negatively correlated with serum ferritin level and malnutrition inflammation score. On multiple linear regression analyses, which were performed to assess the potential predictors of the peak Vo2, the malnutrition inflammation score was the only variable that independently correlated with the peak Vo2 in hemodialysis patients awaiting renal transplantation.

In conclusion, peak Vo2 is associated with markers of nutrition and the malnutrition inflammation score. We suggest that chronic malnutrition and silent inflammation may be responsible for the preoperative decreased exercise capacity in renal transplantation candidates undergoing hemodialysis.

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Patients and Methods

Thirty patients with chronic renal failure who were undergoing hemodialysis and waiting for renal transplantation included 14 women and 16 men of overall mean age of 40.2 ± 10.3 years and a duration of dialysis of 133.1 ± 63.3 months. The study was approved by the local ethics committee, and all patients provided informed consent. No patient had signs or symptoms of active infection or inflammation. We excluded individuals who had clinically evident malnutrition, malignancy, or a chronic

Results

The most common causes of ESRD were vesicoureteral reflux and nephrolithiasis, which were present in 10 (33.4%) of the patients included in the study. The cause of ESRD was glomerulonephritis in 8 patients (26.7%), hypertension in 4 (13.3%), polycystic kidney disease in 3 (10.0%), amyloidosis in 1 (3.3%), and unknown in 4 (13.3%).

Table 1 shows the PFT and CPET results, the MIS, and the biochemical parameters of the 30 hemodialysis patients. The MIS was negatively correlated with the peak Vo2 (r

Discussion

In our study, we observed that, among hemodialysis patients awaiting renal transplantation, exercise capacity reflected by the peak Vo2 was negatively correlated with the MIS. Peak Vo2 was positively correlated with the serum triglyceride level and negatively with the serum ferritin level. The results of a multiple linear regression analysis showed that only the MIS was independently correlated with the peak Vo2 in hemodialysis patients awaiting renal transplantation.

The low peak Vo2 in chronic

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  • Impact of Resistance Training on Factors Involved in the Development of New-Onset Diabetes After Transplantation in Renal Transplant Recipients: An Open Randomized Pilot Study

    2016, Canadian Journal of Diabetes
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    In addition, as observed in type 2 diabetes, insulin resistance and decreased insulin secretion favour the development of NODAT (7). Patients with chronic kidney failure demonstrate limitations in exercise capacity secondary to muscle weakness (8–12). There is also impairment in cardiorespiratory fitness levels related to peripheral muscle dysfunction (13,14).

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