Physical activity parameters as determinants of cardiovascular disease risk in kidney transplant recipients: an accelerometer-based study

Introduction:
Cardiovascular diseases are the leading cause of morbidity and mortality after kidney transplantation. Physical inactivity is an important factor for the development of cardiovascular disease (CVD) risk.

Aim:
To evaluate CVD risk and its association with accelerometer-based physical activity (PA) parameters in kidney transplant recipients (KTRs).

Material and methods:
This cross-sectional study included 43 KTRs. Number of steps, total energy expenditure, average sleep and lying times, average metabolic equivalent (MET), and PA duration were assessed with SenseWear Armband. CVD risk was predicted using a web-based interactive tool (HeartScore program).

Results:
CVD risk was negatively correlated with number of steps, average MET and PA duration. Average MET and PA duration were significantly higher in KTRs with low CVD risk compared to KTRs with moderate CVD risk (p = 0.004 and p = 0.007, respectively). Average MET, PA duration and number of steps were significantly higher in KTRs with low CVD risk compared to KTRs with high CVD risk (p < 0.001, p < 0.001 and p = 0.009, respectively). Number of steps was higher in KTRs with moderate CVD risk compared to KTRs with high CVD risk (p = 0.010). The linear regression analysis revealed that average MET was a predictor of CVD risk, accounting for 15.9% of the variance.

Conclusions:
CVD risk is associated with accelerometer-based PA parameters and average MET is a significant predictor of CVD risk after kidney transplantation into ‘in KTRs. Wearable technologies can be used to objectively measure PA parameters in order to determine CVD risk and to monitor the efficiency of PA interventions after kidney transplantation.