Key result
Over ~3 years following renal transplant, relative VO2peak declined significantly from 15.2 to 12.2 mL/kg/min, driven primarily by an adverse response group.
Why the study?
VO2peak improves short-term after renal transplant, but long-term changes remain uncharacterized despite being an important predictor of mortality in renal disease.
Does renal transplant improve long-term peak oxygen uptake (VO2peak) in patients with renal disease?
Cohort (n=18)
Does renal transplant improve long-term peak oxygen uptake (VO2peak) in patients with renal disease?
Contrary to short-term improvements, long-term peak oxygen uptake significantly declines over 3 years following renal transplantation.
VO2peak may decline long-term post-transplant in some patients; exploratory Level 5 data leaves open validation and clinical relevance in larger cohorts.
Peak oxygen uptake (VO2peak) is an important predictor of cardiovascular and all-cause mortality in patients with renal disease. VO2peak worsens in patients with chronic renal disease and has been reported to improve in the short term (6-month time period) following renal transplant. However, long-term changes in VO2peak following renal transplant remain uncharacterized. We examined changes in VO2peak over ~3 years of follow-up after renal transplant in 18 patients (age—56.2 ± 2.5 years, BMI—29.7 ± 6). VO2peak was quantified using a treadmill ramp test prior to and following renal transplantation. Subjects were classified as stable vs adverse responders based on changes in VO2peak on follow-up. Relative VO2peak declined significantly from 15.2 ± 0.8 mL/kg/min to 12.2 ± 0.4 mL/kg/min (~20% reduction) in the entire cohort principally driven by reductions in the adverse response group (n = 10; pre—16.5 ± 1.1, post—11.9 ± 0.5 mL/kg/min) that had greater reductions in VO2peak compared with the stable group (n = 8; pre—13.7 ± 0.7, post—12.5 ± 0.7 mL/kg/min). There were significantly greater hospitalizations in the adverse response group as well. The trends demonstrated in our exploratory study of 18 patients need to be examined and validated in larger cohorts.
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Angadi et al. (2021) conducted a cohort in Renal transplant (n=18). Renal transplant vs. Pre-transplant baseline was evaluated on Relative VO2peak (mL/kg/min) (~20% reduction). Over ~3 years following renal transplant, relative VO2peak declined significantly from 15.2 to 12.2 mL/kg/min, driven primarily by an adverse response group.
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