Effect of kidney transplantation on indices of cardiorespiratory fitness assessed with cardiopulmonary exercise testing: a systematic review and meta-analysis.

IF 2.9 3区医学 Q2 RESPIRATORY SYSTEM

Expert Review of Respiratory Medicine Pub Date : 2023-02-01 DOI:10.1080/17476348.2023.2182772

Eva Pella, Maria-Eleni Alexandrou, Afroditi Boutou, Marieta Theodorakopoulou, Konstantina Dipla, Andreas Zafeiridis, Pantelis Sarafidis

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引用次数: 0

Abstract

Background: Patients with kidney failure often present with reduced cardiovascular reserve. Kidney transplantation (KT) is the optimal treatment for patients with end-stage kidney disease as it is associated with longer survival and improved quality of life compared to dialysis.

Methods: This is a systematic review and meta-analysis of studies using cardiopulmonary-exercise-testing to examine the cardiorespiratory fitness of patients with kidney failure before and after KT. The primary outcome was difference in pre- and post-transplantation values of peak oxygen uptake (VO2peak). Literature search involved three databases (PubMed-Web of Science-Scopus), manual search, and grey literature.

Results: From 379 records initially retrieved, six studies were included in final meta-analysis. A marginal, but not significant, improvement was observed in VO2peak after KT compared to pre-transplantation values (SMD: 0.32, 95%CI -0.02; 0.67). Oxygen consumption at anaerobic threshold was significantly improved after KT (WMD: 2.30 ml/kg/min, 95%CI 0.50; 4.09). Consistent results were shown between preemptive and after-dialysis-initiation transplantation and a trend for improvement in VO2peak was observed at least 3 months post-transplantation, but not earlier.

Conclusion: Several major indices of cardiorespiratory fitness tend to improve after KT. This finding may represent another modifiable factor contributing to better survival rates of kidney transplant recipients compared to patients undergoing dialysis.

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肾移植对心肺运动试验评估的心肺功能指标的影响:系统回顾和荟萃分析。

背景:肾衰竭患者常表现为心血管储备减少。肾移植(KT)是终末期肾病患者的最佳治疗方法，因为与透析相比，它与更长的生存期和更高的生活质量有关。方法:这是一项系统综述和荟萃分析，研究使用心肺运动测试来检查肾衰患者在KT前后的心肺功能。主要结果是移植前后的峰值摄氧量(vo2峰值)值的差异。文献检索涉及三个数据库(PubMed-Web of Science-Scopus)、人工检索和灰色文献。结果:从最初检索的379份记录中，有6项研究被纳入最终的荟萃分析。与移植前值相比，KT后vo2峰值有轻微但不显著的改善(SMD: 0.32, 95%CI -0.02;0.67)。KT后厌氧阈耗氧量显著提高(WMD: 2.30 ml/kg/min, 95%CI 0.50;4.09)。预先移植和透析后开始移植的结果一致，并且在移植后至少3个月观察到vo2峰值的改善趋势，但不早于此。结论:KT术后心肺功能指标有改善的趋势。这一发现可能代表了另一个可改变的因素，有助于肾移植受者比接受透析的患者生存率更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Respiratory Medicine RESPIRATORY SYSTEM-

CiteScore

6.80

自引率

2.60%

发文量

期刊介绍： Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity