Can Solid-Organ-Transplanted Patients Perform a Cycling Marathon? Trends in Kidney Function Parameters in Comparison With Healthy Subjects.
BACKGROUND
Few solid-organ-transplanted patients (TP) perform regular sport activity. Poor data are available on the safety of intense and prolonged physical exercise on this population. The aim of the study was to evaluate kidney function parameters in a group of TP in comparison with healthy volunteers (HV) involved in a long-distance road cycling race: length 130 km and total uphill gradient, 1871 m.


METHODS
Nineteen TP were recruited: 10 renal, 8 liver, and 1 heart and compared with 35 HV. Renal function parameters, namely, creatinine, estimated glomerular filtration rate (eGFR), urea, uric acid, urine specific gravity, microalbuminuria, and proteinuria were collected and their values were compared the day before the race (T1), immediately after crossing the finish line (T2), and 18 to 24 hours after the competition (T3).


RESULTS
No adverse events were recorded. At baseline, TP showed lower values of eGFR (69 ± 22 versus 87 ± 13 mL/min/1.73 m(2)), lower urine specific gravity (1015 ± 4 versus 1019 ± 6), and higher microalbuminuria (56 ± 74 versus 8 ± 15) and proteinuria values (166 ± 99 versus 74 ± 44) (in mg/L). At T2 in both groups, renal function parameters showed the same trends: decline of eGFR (54 ± 19 versus 69 ± 15 mL/min/1.73 m(2)) and rise in protein excretion. At T3, functional parameters returned to baseline, except for urine specific gravity values remaining stable in TP (1018 ± 6) and growing higher in HV (1028 ± 4).


CONCLUSIONS
Selected and well-trained organ-transplanted patients can perform an intensive exercise, displaying temporary modifications on kidney function parameters comparable to healthy subjects, despite differences related to baseline clinical conditions and pharmacological therapies.
Unit of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì, Italy.
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Mosconi
Unit of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì, Italy.
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ML
Angelini
Unit of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì, Italy.
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W
Balzi
Emilia Romagna Transplant Reference Centre (CRT-ER), Italy.
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V
Totti
Isokinetic Medical Group, Bologna, Italy.
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GS
Roi
Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Section of Nephrology, University of Bologna, Bologna, Italy.
M
M
Cappuccilli
Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), Section of Nephrology, University of Bologna, Bologna, Italy.
M
M
Tonioli
Italian National Transplant Centre, Rome, Italy.
D
D
Storani
Italian National Transplant Centre, Rome, Italy.
M
M
Trerotola
Italian National Transplant Centre, Rome, Italy. Electronic address: daniela.storani@iss.it.
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Costa
D000328:Adult; D000419:Albuminuria; D001642:Bicycling / Q000502:physiology*; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood*; D015444:Exercise / Q000502:physiology*; D005260:Female; D005919:Glomerular Filtration Rate; D064368:Healthy Volunteers; D016027:Heart Transplantation; D006801:Humans; D007668:Kidney; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011507:Proteinuria; D013046:Specific Gravity; D066027:Transplant Recipients; D014508:Urea / Q000097:blood*; D014527:Uric Acid / Q000097:blood*; D014556:Urine
D014527:Uric Acid; D014508:Urea; D003404:Creatinine