Transplant Trial Watch

Physical activity and risk of cardiovascular events and all-cause mortality among kidney transplant recipients.

Kang, A. W., et al.

Nephrology Dialysis Transplantation 2020 [record in progress]

This is a post-hoc analyis of the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial. The aim of this study was to investigate the association of physical activity (PA) with cardiovascular (CVD) events, CVD deaths and all-cause mortality among renal transplant recipients.

Participants were randomized to two arms: the high dose multivitamin arm, where they received a multivitamin with increased folic acid, vitamin B6 and B12 ; and the low dose multivitamin arm, where they received a multivitamin with no folic acid and estimated average amounts of vitamin B6 and B12.

3050 kidney transplant recipients from the FAVORIT trial.

The outcomes of interest were the risk of CVD events, CVD deaths and all-cause deaths in kidney transplant recipients measured across Yale Physical Activity Survey (YPAS) tertiles (T1, T2, T3 and T4) of physical activity.

3.7 years (mean)

CET Conclusions
This is a post-hoc analysis from an international RCT, the FAVORIT study. Data was used from over 3000 kidney transplant recipients, stratified by physical activity levels to assess the impact on cardiac events, cardiovascular mortality and all-cause mortality. Physical activity was assessed at baseline across 5 domains: vigorous activity, leisurely walking, moving on feet, standing and sitting. Mean follow up was 3.7 years. Higher physical activity scores were associated with lower risk of cardiac events, cardiovascular mortality and all-cause mortality when comparing the most active with the least active groups. The association was preserved when controlling for other known predictors of cardiovascular disease. This is not really a surprising conclusion but it is the first large, multicentre study clearly showing this association. In criticism, the physical activity scores were only obtained at baseline so it is unclear if changes in physical activity after transplantation are associated with cardiovascular risk.

Trial registration - NCT00064753

Funding source
Non-industry funded