Title

Cardiorespiratory fitness in pediatric renal transplant recipients

UMMS Affiliation

Department of Pediatrics

Publication Date

2009-08-15

Document Type

Article

Subjects

Absorptiometry, Photon; Adiposity; Adolescent; Body Height; Body Weight; Case-Control Studies; Child; Continental Population Groups; Cross-Sectional Studies; Exercise Test; Female; Humans; Kidney Transplantation; Male; *Oxygen Consumption; *Physical Fitness; Regression Analysis; Risk Assessment; Risk Factors; Sex Factors; Treatment Outcome; Young Adult

Disciplines

Nephrology | Pediatrics

Abstract

BACKGROUND: The impact of body size, fat-free mass (FFM), and fat mass (FM) on cardiorespiratory fitness in pediatric renal transplant recipients (TX) has not been established. Study objectives were to assess maximal oxygen consumption (VO2max) in TX and controls, adjusted for body composition, and to identify risk factors for reduced fitness in TX.

METHODS: Cycle ergometry and dual-energy X-ray absorptiometry were obtained in 50 TX and 70 controls, ages 8 to 21 years. Control recruitment was targeted to include obese subjects with body mass index Z-scores comparable with TX. Allometric regression models were used.

RESULTS: TX had significantly lower height Z-scores (P<0.001) and comparable body mass index Z-scores. VO2max per body weight (mL/kg/min) and per FFM (mL/kgFFM/min) did not differ between groups. However, VO2max was 13% lower (95% CI 18, 8; P<0.001) in TX, compared with controls, adjusted for FM, FFM, sex, and race. Greater FFM, lower FM, non-black race, and male sex were independently associated with greater VO2max. Within TX, hemoglobin levels were positively associated with VO2max (P=0.04) and sirolimus use was associated with lower VO2max (P<0.01).

CONCLUSIONS: TX had significant VO2max deficits that were not captured by conventional measures (mL/kg/min). Greater FM was an independent risk factor for low VO2max. Lower fitness in TX may be related to sirolimus effects on skeletal muscle.

DOI of Published Version

10.1097/TP.0b013e3181aed7d1

Source

Transplantation. 2009 Aug 15;88(3):395-401. Link to article on publisher's site

Journal/Book/Conference Title

Transplantation

Related Resources

Link to Article in PubMed

PubMed ID

19667944

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