A Novel and Personalized Rehabilitation Program for Obese Kidney Transplant Recipients

• Published in: Transplantation proceedings Vol. 46; no. 10; pp. 3431 - 3437
• Main Authors: Tzvetanov, I, West-Thielke, P, D'Amico, G, Johnsen, M, Ladik, A, Hachaj, G, Grazman, M, Heller, R.U, Fernhall, B, Daviglus, M.L, Solaro, R.J, Oberholzer, J, Gallon, L, Benedetti, E
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2014
• Subjects: Body Mass Index; Exercise - physiology; Exercise Therapy - methods; Female; Glomerular Filtration Rate; Humans; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - surgery; Kidney Transplantation; Male; Middle Aged; Obesity - complications; Obesity - rehabilitation; Prospective Studies; Quality of Life; Surgery; Transplant Recipients
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2014.05.085

Abstract Introduction Physical rehabilitation programs for kidney transplant recipients are not routinely personalized to patients' physical and emotional health, which could result in a potentially limited health impact, shorter-term participation, and an overall low success rate. Materials and Methods We conducted an internal review board–approved randomized prospective study involving a 12-month supervised multidisciplinary rehabilitation program (GH method) initiated after kidney transplantation in obese recipients (body mass index >30). The new method incorporates 3 major components: physical exercise, behavioral interventions, and nutritional guidance. We compared 9 patients who underwent supervised rehabilitation with 8 patients who underwent standard care. Patients were followed up after the start of the intervention, and multiple assessments were performed. Results The adherence to training and follow-up was 100% in the intervention group, compared with 25% at 12 months in the control group. There was a trend for a higher glomerular filtration rate in the intervention group compared with the control group (55.5 ± 18.6 mL/min/1.73 m2 vs 38.8 ± 18.9 mL/min/1.73 m2 , P  = .06). The quality of life (SF-36) mean score improved more in the intervention group compared with the control group (583 ± 13 vs 436 ± 22, P  = .008). There was a significantly higher employment rate in the intervention group, 77.7% at 12 months compared with 12.5% in the control group ( P  = .02). Conclusions Our preliminary results suggest that this comprehensive approach to physical rehabilitation can improve adherence, kidney function, quality of life, and employment rate for obese patients after kidney transplantation.