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      HEALTH-RELATED FITNESS AND QUALITY OF LIFE IN ORGAN TRANSPLANT RECIPIENTS1,2

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          The quality of life of patients with end-stage renal disease.

          We assessed the quality of life of 859 patients undergoing dialysis or transplantation, with the goal of ascertaining whether objective and subjective measures of the quality of life were influenced by case mix or treatment. We found that 79.1 per cent of the transplant recipients were able to function at nearly normal levels, as compared with between 47.5 and 59.1 per cent of the patients treated with dialysis (depending on the type). Nearly 75 per cent of the transplant recipients were able to work, as compared with between 24.7 and 59.3 per cent of the patients undergoing dialysis. On three subjective measures (life satisfaction, well-being, and psychological affect) transplant recipients had a higher quality of life than patients on dialysis. Among the patients treated with dialysis, those undergoing treatment at home had the highest quality of life. All quality-of-life differences were found to persist even after the patient case mix had been controlled statistically. Finally, the quality of life of transplant recipients compared well with that of the general population, but despite favorable subjective assessments, patients undergoing dialysis did not work or function at the same level as people in the general population.
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            Risk factors for accelerated atherosclerosis in renal transplant recipients.

            The factors responsible for atherosclerosis in renal transplant recipients are not known. In the present study, cardiovascular disease was investigated in 403 patients who received 464 kidney transplants during a 10-year period. Among those who had no clinical evidence of vascular disease at the time of transplantation, atherosclerotic complications developed in 15.8 percent during the post-transplant follow-up period (46.1 +/- 36.2 months). Pre- and post-transplant vascular diseases were closely linked. However, after taking pre-transplant vascular disease into account, multivariate analysis showed that a number of known risk factors (age, sex, diabetes, cigarette smoking, hypertension, and serum cholesterol) were independently associated with post-transplant vascular disease. In addition, the number of acute rejection episodes (all treated with high doses of corticosteroids) was also independently linked to vascular disease. These results suggest that an increased prevalence of known risk factors, and events linked to allograft rejection, explain the high incidence of cardiovascular disease in renal transplant recipients.
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              Exercise Capacity in Hemodialysis, CAPD, and Renal Transplant Patients

              Eighteen hemodialysis, 12 chronic ambulatory peritoneal dialysis (CAPD), and 20 renal transplant patients performed maximal treadmill exercise tests. Heart rates and blood pressures were determined every minute and maximal oxygen consumption was measured directly. Exercise capacity as measured by VO 2 max is low in dialysis patients and similar to sedentary normal individuals in renal transplant patients. Maximal heart rates were significantly lower in hemodialysis patients than transplant recipients. The lower exercise tolerance in end-stage renal disease indicates that most patients regardless of the treatment mode could benefit from attempts through exercise training to increase physical working capacity.
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                Author and article information

                Journal
                Transplantation
                Transplantation
                Ovid Technologies (Wolters Kluwer Health)
                0041-1337
                1997
                December 1997
                : 64
                : 12
                : 1795-1800
                Article
                10.1097/00007890-199712270-00029
                c20fd6d2-2878-4617-be98-1d5aca754430
                © 1997
                History

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