Exercise attitudes and practices among adults listed for kidney transplantation: a survey of a diverse patient cohort

Abstract

Background: Given the increasing age and frailty of kidney transplant candidates, there is an emerging drive to optimise patients before transplantation. Lack of exercise has been linked with poor outcomes at all stages of the transplant pathway. The aim of this study was to evaluate the attitudes and perception to exercise in such patients and assess how these practises vary by demographics.

Methods: A single-centre, prospective, survey-based study was conducted on consecutive adult patients being assessed for activation on the deceased-donor kidney transplant waiting list.

Results: A total of 103 patients (65% male; 56% White ethnicity; mean age: 47.8 years) completed the survey. Of these, 42% were on haemodialysis and 24% on peritoneal dialysis. Most patients agreed/strongly agreed that exercise was important (86%) and that they would be willing to do so to optimise their health (97%). Despite this, only 56% of patients reported exercising on a regular basis. Most patients stated that they would be willing to wear exercise monitoring devices (81%). Younger (Spearman's rho: 0.20, p = 0.047) and Black/Asian ethnicity (p = 0.038) patients reported performing significantly less exercise activity than their older and White counterparts.

Conclusion: Whilst kidney transplant candidates have generally positive attitudes toward exercise, only around half of those surveyed reported exercising regularly. The findings of this study, including differences across age and ethnicity, would be useful to consider when designing patient-centred prehabilitation interventions to encourage exercise in this cohort.

Keywords: attitudes; exercise; kidney transplantation; prehabilitation; waiting list.

Figure 1

Responses to Likert-scale questions. The wording of some questions is shortened for brevity; the original text of each question is reported in Table 1. Percentages are calculated based on the number of patients that gave a response to the stated question, as reported in Table 3. For questions I) and J), the activities/factors are sorted in descending order, based on the mean response. Unlabelled bars have a frequency of <5%. *For patients on haemodialysis. **Excludes patients answering “not applicable”, i.e., those without fluid restrictions.

Figure 2

Associations between patient characteristics and exercise frequency. The wording of some questions is shortened for brevity; the original text of each question is reported in Table 1. Percentages are calculated based on the number of patients that gave a response to the stated question, as reported in Table 3. Unlabelled bars have a frequency of <5%. *The mixed/other group was excluded from analysis, due to the small sample size. **Excludes patients answering “not applicable”, i.e., those without fluid restrictions. BMI, body mass index.