Pub Date : 2022-08-04DOI: 10.3390/kidneydial2030040
Henry H. L. Wu, R. Chinnadurai, R. Walker
Anemia in chronic kidney disease (CKD) has become an important clinical issue with the increased prevalence of elderly patients living with CKD progressing to kidney failure. The causes of anemia in elderly individuals tend to be multifactorial, exacerbated by the physiological effects of aging, frailty and declining kidney function. Erythropoiesis-stimulating agents (ESAs) are the conventional therapeutic option for anemia in CKD. However, ESA hyporesponsiveness is a commonly observed issue in clinical practice and an issue that is more challenging to resolve in elderly patients living with frailty, kidney disease, and multi-morbidities. Following the emergence of oral hypoxia-induced factor prolyl-hydroxylase inhibitors (HIF-PHI) in recent years, there is discussion on whether it is a solution to the conundrum of ESA hyporesponsiveness, as HIF-PHI treats anemia via an alternative physiological pathway. There remains uncertainty on the suitability of HIF-PHI use in elderly patients, given a lack of data on its safety over long-term follow-up for the elderly population. Further study is needed to provide answers, considering the clinical significance of this issue within a public-health scale.
{"title":"Is HIF-PHI the Answer to Tackle ESA Hyporesponsiveness in the Elderly?","authors":"Henry H. L. Wu, R. Chinnadurai, R. Walker","doi":"10.3390/kidneydial2030040","DOIUrl":"https://doi.org/10.3390/kidneydial2030040","url":null,"abstract":"Anemia in chronic kidney disease (CKD) has become an important clinical issue with the increased prevalence of elderly patients living with CKD progressing to kidney failure. The causes of anemia in elderly individuals tend to be multifactorial, exacerbated by the physiological effects of aging, frailty and declining kidney function. Erythropoiesis-stimulating agents (ESAs) are the conventional therapeutic option for anemia in CKD. However, ESA hyporesponsiveness is a commonly observed issue in clinical practice and an issue that is more challenging to resolve in elderly patients living with frailty, kidney disease, and multi-morbidities. Following the emergence of oral hypoxia-induced factor prolyl-hydroxylase inhibitors (HIF-PHI) in recent years, there is discussion on whether it is a solution to the conundrum of ESA hyporesponsiveness, as HIF-PHI treats anemia via an alternative physiological pathway. There remains uncertainty on the suitability of HIF-PHI use in elderly patients, given a lack of data on its safety over long-term follow-up for the elderly population. Further study is needed to provide answers, considering the clinical significance of this issue within a public-health scale.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48570380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.3390/kidneydial2030039
Asheesh Kumar, Ramjeewan Singh
TCC placement is a skilled procedure; one must be aware of possible complications, particularly those related to the positioning of catheters, which are vital for the proper functioning of catheters and hemodialysis procedure. It is also equally important to be familiar with the appropriate management if such complications are encountered.
{"title":"Cephalad Migration of Tunneled-Cuffed Catheter: The Importance of Post Procedure Imaging","authors":"Asheesh Kumar, Ramjeewan Singh","doi":"10.3390/kidneydial2030039","DOIUrl":"https://doi.org/10.3390/kidneydial2030039","url":null,"abstract":"TCC placement is a skilled procedure; one must be aware of possible complications, particularly those related to the positioning of catheters, which are vital for the proper functioning of catheters and hemodialysis procedure. It is also equally important to be familiar with the appropriate management if such complications are encountered.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48368733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.3390/kidneydial2030038
E. Hoogeveen
Globally, the incidence and prevalence of diabetes mellitus has risen dramatically, owing mainly to the increase in type 2 diabetes mellitus (T2DM). In 2021, 537 million people worldwide (11% of the global population) had diabetes, and this number is expected to increase to 783 million (12%) by 2045. The growing burden of T2DM is secondary to the pandemic of obesity, which in turn has been attributed to increased intake of processed food, reduced physical activity, and increased sedentary behaviour. This so-called western lifestyle is related with the global increase in urbanization and technological development. One of the most frequent and severe long-term complications of diabetes is diabetic kidney disease (DKD), defined as chronic kidney disease in a person with diabetes. Approximately 20–50% of patients with T2DM will ultimately develop DKD. Worldwide, DKD is the leading cause of chronic kidney disease and end-stage kidney disease, accounting for 50% of cases. In addition, DKD results in high cardiovascular morbidity and mortality, and decreases patients’ health-related quality of life. In this review we provide an update of the diagnosis, epidemiology, and causes of DKD.
{"title":"The Epidemiology of Diabetic Kidney Disease","authors":"E. Hoogeveen","doi":"10.3390/kidneydial2030038","DOIUrl":"https://doi.org/10.3390/kidneydial2030038","url":null,"abstract":"Globally, the incidence and prevalence of diabetes mellitus has risen dramatically, owing mainly to the increase in type 2 diabetes mellitus (T2DM). In 2021, 537 million people worldwide (11% of the global population) had diabetes, and this number is expected to increase to 783 million (12%) by 2045. The growing burden of T2DM is secondary to the pandemic of obesity, which in turn has been attributed to increased intake of processed food, reduced physical activity, and increased sedentary behaviour. This so-called western lifestyle is related with the global increase in urbanization and technological development. One of the most frequent and severe long-term complications of diabetes is diabetic kidney disease (DKD), defined as chronic kidney disease in a person with diabetes. Approximately 20–50% of patients with T2DM will ultimately develop DKD. Worldwide, DKD is the leading cause of chronic kidney disease and end-stage kidney disease, accounting for 50% of cases. In addition, DKD results in high cardiovascular morbidity and mortality, and decreases patients’ health-related quality of life. In this review we provide an update of the diagnosis, epidemiology, and causes of DKD.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46483296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-12DOI: 10.3390/kidneydial2030037
K. Richardson, Luke T. Richardson, R. Bowden
Previous findings assessing the relationship between high-density lipoprotein cholesterol (HDL-c) and kidney function have demonstrated contradictory results including positive, negative, and U-shaped relationships. Many prior studies in this area have been conducted in healthy populations, but few have considered the influence of metabolic health status. In the present study, a cross-sectional analysis was conducted using complex survey sample weighting in the assessment of 6455 subjects from the 2013–2018 National Health and Nutrition Examination Surveys (NHANES), representative of 94,993,502 United States citizens. Subjects were classified as metabolically healthy or unhealthy and linear regression analyses were performed to evaluate the influence of HDL-c on estimated glomerular filtration rate (eGFR). HDL-c was found to be negatively associated with eGFR in the metabolically healthy, unhealthy, and combined groups (B = −0.16, p < 0.0001, B = −0.21, p < 0.0001, and B = −0.05, p = 0.0211, respectively). This relationship persisted after adjustment for confounding variables (B = −0.24, p < 0.0001, B = −0.17, p < 0.001, and B = −0.18, p < 0.0001, respectively). The relationship between HDL-c and eGFR was found to be a negative linear association, rather than a U-shaped association, and it persisted in all models tested, despite statistical adjustment for confounding variables. After controlling the samples for outliers, the negative relationship between HDL-c and eGFR was attenuated in the healthy and total groups but remained significant in the MetS group, indicating a stronger relationship between HDL-c and eGFR in those with poorer health.
先前评估高密度脂蛋白胆固醇(HDL-c)与肾功能之间关系的研究结果显示出相互矛盾的结果，包括正、负和u型关系。这方面的许多研究都是在健康人群中进行的，但很少考虑代谢健康状态的影响。在本研究中，对来自2013-2018年国家健康与营养检查调查(NHANES)的6455名受试者进行了复杂的调查样本加权评估，进行了横断面分析，代表了94,993,502名美国公民。将受试者分为代谢健康或不健康，并进行线性回归分析以评估HDL-c对肾小球滤过率(eGFR)的影响。在代谢健康组、代谢不健康组和合并组中，HDL-c与eGFR呈负相关(B = - 0.16, p < 0.0001, B = - 0.21, p < 0.0001, B = - 0.05, p = 0.0211)。在调整混杂变量后，这种关系仍然存在(B = - 0.24, p < 0.0001, B = - 0.17, p < 0.001, B = - 0.18, p < 0.0001)。发现HDL-c和eGFR之间的关系是负线性关联，而不是u形关联，并且在所有测试的模型中都存在，尽管对混杂变量进行了统计调整。在控制样本的异常值后，HDL-c和eGFR之间的负相关关系在健康组和总组中减弱，但在MetS组中仍然显著，这表明HDL-c和eGFR之间的关系在健康状况较差的人群中更强。
{"title":"Association of High-Density Lipoprotein Cholesterol, Renal Function, and Metabolic Syndrome: An Assessment of the 2013–2018 National Health and Nutrition Examination Surveys","authors":"K. Richardson, Luke T. Richardson, R. Bowden","doi":"10.3390/kidneydial2030037","DOIUrl":"https://doi.org/10.3390/kidneydial2030037","url":null,"abstract":"Previous findings assessing the relationship between high-density lipoprotein cholesterol (HDL-c) and kidney function have demonstrated contradictory results including positive, negative, and U-shaped relationships. Many prior studies in this area have been conducted in healthy populations, but few have considered the influence of metabolic health status. In the present study, a cross-sectional analysis was conducted using complex survey sample weighting in the assessment of 6455 subjects from the 2013–2018 National Health and Nutrition Examination Surveys (NHANES), representative of 94,993,502 United States citizens. Subjects were classified as metabolically healthy or unhealthy and linear regression analyses were performed to evaluate the influence of HDL-c on estimated glomerular filtration rate (eGFR). HDL-c was found to be negatively associated with eGFR in the metabolically healthy, unhealthy, and combined groups (B = −0.16, p < 0.0001, B = −0.21, p < 0.0001, and B = −0.05, p = 0.0211, respectively). This relationship persisted after adjustment for confounding variables (B = −0.24, p < 0.0001, B = −0.17, p < 0.001, and B = −0.18, p < 0.0001, respectively). The relationship between HDL-c and eGFR was found to be a negative linear association, rather than a U-shaped association, and it persisted in all models tested, despite statistical adjustment for confounding variables. After controlling the samples for outliers, the negative relationship between HDL-c and eGFR was attenuated in the healthy and total groups but remained significant in the MetS group, indicating a stronger relationship between HDL-c and eGFR in those with poorer health.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42854909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-11DOI: 10.3390/kidneydial2030036
M. Pruijm, Ibtisam Aslam, B. Milani, W. Brito, M. Burnier, N. Selby, J. Vallée
Diabetic kidney disease (DKD) is a major public health problem and its incidence is rising. The disease course is unpredictable with classic biomarkers, and the search for new tools to predict adverse renal outcomes is ongoing. Renal magnetic resonance imaging (MRI) now enables the quantification of metabolic and microscopic properties of the kidneys such as single-kidney, cortical and medullary blood flow, and renal tissue oxygenation and fibrosis, without the use of contrast media. A rapidly increasing number of studies show that these techniques can identify early kidney damage in patients with DKD, and possibly predict renal outcome. This review provides an overview of the currently most frequently used techniques, a summary of the results of some recent studies, and our view on their potential applications, as well as the hurdles to be overcome for the integration of these techniques into the clinical care of patients with DKD.
{"title":"Magnetic Resonance Imaging to Diagnose and Predict the Outcome of Diabetic Kidney Disease—Where Do We Stand?","authors":"M. Pruijm, Ibtisam Aslam, B. Milani, W. Brito, M. Burnier, N. Selby, J. Vallée","doi":"10.3390/kidneydial2030036","DOIUrl":"https://doi.org/10.3390/kidneydial2030036","url":null,"abstract":"Diabetic kidney disease (DKD) is a major public health problem and its incidence is rising. The disease course is unpredictable with classic biomarkers, and the search for new tools to predict adverse renal outcomes is ongoing. Renal magnetic resonance imaging (MRI) now enables the quantification of metabolic and microscopic properties of the kidneys such as single-kidney, cortical and medullary blood flow, and renal tissue oxygenation and fibrosis, without the use of contrast media. A rapidly increasing number of studies show that these techniques can identify early kidney damage in patients with DKD, and possibly predict renal outcome. This review provides an overview of the currently most frequently used techniques, a summary of the results of some recent studies, and our view on their potential applications, as well as the hurdles to be overcome for the integration of these techniques into the clinical care of patients with DKD.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43479452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-05DOI: 10.3390/kidneydial2030035
A. Kaplan, W. Szpirt
For over thirty-five years, available data suggested that therapeutic plasma exchange (TPE) was a useful treatment for patients with Rapidly Progressive Glomerulonephritis (RPGN) associated with ANCA Associated Vasculitis (AAV) and elevated creatinine levels. The publication of the PEXIVAS study has challenged this conclusion. This perspective will outline the history of this issue and present our assessment of the current status.
{"title":"Should We Still Use Therapeutic Plasma Exchange for Rapidly Progressive Glomerulonephritis in ANCA Associated Vasculitis?","authors":"A. Kaplan, W. Szpirt","doi":"10.3390/kidneydial2030035","DOIUrl":"https://doi.org/10.3390/kidneydial2030035","url":null,"abstract":"For over thirty-five years, available data suggested that therapeutic plasma exchange (TPE) was a useful treatment for patients with Rapidly Progressive Glomerulonephritis (RPGN) associated with ANCA Associated Vasculitis (AAV) and elevated creatinine levels. The publication of the PEXIVAS study has challenged this conclusion. This perspective will outline the history of this issue and present our assessment of the current status.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47340408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-23DOI: 10.3390/kidneydial2030033
S. Schukraft, R. Hullin
Worsening renal function is associated with poor outcomes in heart failure and often accompanies the initiation and up-titration of guidelines-directed heart failure therapy. This narrative review summarizes current evidence on immediate and long-term effects of pharmacological or device-based treatment in heart failure patients with reduced or preserved left ventricular ejection fraction.
{"title":"Cardiorenal Crosstalk in Patients with Heart Failure","authors":"S. Schukraft, R. Hullin","doi":"10.3390/kidneydial2030033","DOIUrl":"https://doi.org/10.3390/kidneydial2030033","url":null,"abstract":"Worsening renal function is associated with poor outcomes in heart failure and often accompanies the initiation and up-titration of guidelines-directed heart failure therapy. This narrative review summarizes current evidence on immediate and long-term effects of pharmacological or device-based treatment in heart failure patients with reduced or preserved left ventricular ejection fraction.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45661334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-13DOI: 10.3390/kidneydial2020031
A. Davenport
One of the key goals of hemodialysis is to control sodium balance and volume status. The traditional view is that inter-dialytic sodium gains can be adequately controlled by ultrafiltration with the convective removal of sodium. However, dialyzing all patients using the same dialysate sodium concentration may potentially lead to excessive losses on the one hand and sodium gains on the other depending on dietary sodium intake, resulting in increased intra-dialytic hypotension and cramps, or greater inter-dialytic weight gains and hypertension.
{"title":"Choosing A Dialysate Sodium Concentration for Hemodialysis Patients","authors":"A. Davenport","doi":"10.3390/kidneydial2020031","DOIUrl":"https://doi.org/10.3390/kidneydial2020031","url":null,"abstract":"One of the key goals of hemodialysis is to control sodium balance and volume status. The traditional view is that inter-dialytic sodium gains can be adequately controlled by ultrafiltration with the convective removal of sodium. However, dialyzing all patients using the same dialysate sodium concentration may potentially lead to excessive losses on the one hand and sodium gains on the other depending on dietary sodium intake, resulting in increased intra-dialytic hypotension and cramps, or greater inter-dialytic weight gains and hypertension.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45415741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-10DOI: 10.3390/kidneydial2020030
Lale A. Ertuglu, T. A. Ikizler
Metabolic derangements such as obesity, dyslipidemia, chronic inflammation, and oxidative stress are commonly seen in patients with chronic kidney disease (CKD) and are implicated in the exaggerated cardiovascular disease (CVD) risk observed in this patient population. Lifestyle interventions including healthy dietary patterns and exercise training have been proven effective in modifying these CVD risk factors in the general population. The efficacy and safety of these interventions in CKD patients remain elusive. This review article aims to provide a summary of the current evidence on the effects of different types of dietary and exercise interventions on metabolic biomarkers associated with cardiovascular disease in patients with moderate to advanced CKD.
{"title":"Effects of Diet and Exercise on Metabolic Parameters and Health in Moderate to Advanced Kidney Disease","authors":"Lale A. Ertuglu, T. A. Ikizler","doi":"10.3390/kidneydial2020030","DOIUrl":"https://doi.org/10.3390/kidneydial2020030","url":null,"abstract":"Metabolic derangements such as obesity, dyslipidemia, chronic inflammation, and oxidative stress are commonly seen in patients with chronic kidney disease (CKD) and are implicated in the exaggerated cardiovascular disease (CVD) risk observed in this patient population. Lifestyle interventions including healthy dietary patterns and exercise training have been proven effective in modifying these CVD risk factors in the general population. The efficacy and safety of these interventions in CKD patients remain elusive. This review article aims to provide a summary of the current evidence on the effects of different types of dietary and exercise interventions on metabolic biomarkers associated with cardiovascular disease in patients with moderate to advanced CKD.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48292731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-07DOI: 10.3390/kidneydial2020029
S. Leunis, M. Vandecruys, V. Cornelissen, A. V. Van Craenenbroeck, S. D. De Geest, D. Monbaliu, S. De Smet
Physical inactivity is highly prevalent after solid organ transplantation and leads to unfavourable outcomes. This review aimed to understand posttransplant physical activity behaviour and propose physical activity interventions. Michie’s Behavioural Change Wheel was applied, in which the Context and Implementation of Complex Interventions framework, the Capability-Opportunity-Motivation and Behaviour model, and the Theoretical Domains Framework were embedded. Various contextual factors were found to modulate physical activity behaviour. Promising strategies to promote long-term physical activity included (i) tailoring of physical activity programs to patients’ abilities and preferences; (ii) incitement of intrinsic and autonomous motivation to change; (iii) SMART goals setting (e.g., Specific, Measurable, Achievable, Realistic, Timebound), (iv) autonomy-supportive co-design of action plans; (v) foster new habit formation; (vi) self-monitoring of physical activity; (vii) follow-up opportunities for evaluation and adjustment; (viii) education of transplant recipients, healthcare providers, and the patients’ social network; (iv) improvement of self-efficacy through incremental successes, verbal persuasion, peer modelling, and awareness of exercise-related bodily signals; (x) providing physical activity opportunity within patients’ social and environmental setting; (xi) encouragement and support from patients’ social network and healthcare providers; and (xii) governmental action that alleviates financial barriers and restructures the physical environment to promote physical activity. These new insights may contribute to physical activity program development for transplantation recipients.
{"title":"Physical Activity Behaviour in Solid Organ Transplant Recipients: Proposal of Theory-Driven Physical Activity Interventions","authors":"S. Leunis, M. Vandecruys, V. Cornelissen, A. V. Van Craenenbroeck, S. D. De Geest, D. Monbaliu, S. De Smet","doi":"10.3390/kidneydial2020029","DOIUrl":"https://doi.org/10.3390/kidneydial2020029","url":null,"abstract":"Physical inactivity is highly prevalent after solid organ transplantation and leads to unfavourable outcomes. This review aimed to understand posttransplant physical activity behaviour and propose physical activity interventions. Michie’s Behavioural Change Wheel was applied, in which the Context and Implementation of Complex Interventions framework, the Capability-Opportunity-Motivation and Behaviour model, and the Theoretical Domains Framework were embedded. Various contextual factors were found to modulate physical activity behaviour. Promising strategies to promote long-term physical activity included (i) tailoring of physical activity programs to patients’ abilities and preferences; (ii) incitement of intrinsic and autonomous motivation to change; (iii) SMART goals setting (e.g., Specific, Measurable, Achievable, Realistic, Timebound), (iv) autonomy-supportive co-design of action plans; (v) foster new habit formation; (vi) self-monitoring of physical activity; (vii) follow-up opportunities for evaluation and adjustment; (viii) education of transplant recipients, healthcare providers, and the patients’ social network; (iv) improvement of self-efficacy through incremental successes, verbal persuasion, peer modelling, and awareness of exercise-related bodily signals; (x) providing physical activity opportunity within patients’ social and environmental setting; (xi) encouragement and support from patients’ social network and healthcare providers; and (xii) governmental action that alleviates financial barriers and restructures the physical environment to promote physical activity. These new insights may contribute to physical activity program development for transplantation recipients.","PeriodicalId":74038,"journal":{"name":"Kidney and dialysis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46709089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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