Exercise-Based Prehabilitation for Kidney Transplant Candidates: The FRAILMar Randomized Controlled Trial
Pérez-Sáez, María José (Institut Hospital del Mar d'Investigacions Mèdiques)
Muñoz-Redondo, Elena (Universitat Autònoma de Barcelona)
Morgado-Pérez, Andrea (Institut Hospital del Mar d'Investigacions Mèdiques)
Delcros-Forestier, Lou (Institut Hospital del Mar d'Investigacions Mèdiques)
Bach Pascual, Anna (Institut Hospital del Mar d'Investigacions Mèdiques)
Faura, Anna (Institut Hospital del Mar d'Investigacions Mèdiques)
Redondo-Pachón, Dolores (Institut Hospital del Mar d'Investigacions Mèdiques)
Chamoun, Betty (Institut Hospital del Mar d'Investigacions Mèdiques)
Burballa, Carla (Institut Hospital del Mar d'Investigacions Mèdiques)
Buxeda, Anna (Institut Hospital del Mar d'Investigacions Mèdiques)
Crespo, Marta (Institut Hospital del Mar d'Investigacions Mèdiques)
Marco, Ester (Institut Hospital del Mar d'Investigacions Mèdiques)
Pascual, Julio (Hospital Universitario 12 de Octubre (Madrid))

Data:	2025
Resum:	Rationale & Objective: Kidney transplantation (KT) is the preferred treatment for kidney failure but carries significant post-transplant risks, particularly for frail patients. This study evaluated the effects of an exercise-based prehabilitation program on exercise capacity, muscle function, and muscle size among KT candidates. Study Design: Analysis of functional outcomes within the FRAILMar study, a randomized controlled trial. Setting & Participants: 121 KT candidates on the KT waiting list. Intervention: The intervention group participated in a prehabilitation program comprising 24 exercise sessions (1 hour, 3 times per week for 8 weeks), the control group received standard care. Randomization was stratified by frailty status. Outcomes: The primary outcome was exercise capacity assessed by maximal workload during a cardiopulmonary exercise test. Secondary outcomes included peripheral muscle function, respiratory muscle function, muscle size, and changes in frailty status. Results: The mean age of the 121 individuals who were randomized was 63. 4 years, 76% were men, and 40% were frail (Fried phenotype ≥ 2). 106 patients completed the prehabilitation program and, among them, compared to standard care, prehabilitation significantly improved exercise capacity (+12. 8 watts; [95% CI: 3. 4 to 22. 2]; p=0. 008), handgrip strength (+1. 8 kg; [95% CI: 0. 7 to 2. 8]; p<0. 001), and rectus femoris thickness (+1. 2 mm; [95% CI: 0. 3 to 2. 0]; p=0. 007). Frail patients showed significant improvements across most measures, demonstrating potential benefits for this subgroup. Limitations: This analysis was limited by a short follow-up period and the risk of type I error due to multiple comparisons, even though outcomes were pre-specified. Conclusions: An 8-week exercise-based prehabilitation program may improve KT candidates' exercise capacity, muscle function, and muscle size, effects also observed among frail patients. These findings may inform future research in this area and the evaluation of the value of standardized prehabilitation protocols.
Ajuts:	Instituto de Salud Carlos III PI19/00037
Nota:	Article que forma part d'una tesi per compendi de publicacions. La data d'embargament que ara consta és provisional i es corregirà o s'eliminarà quan es publiqui la versió de l'editor.
Drets:	Aquest material està protegit per drets d'autor i/o drets afins. Podeu utilitzar aquest material en funció del que permet la legislació de drets d'autor i drets afins d'aplicació al vostre cas. Per a d'altres usos heu d'obtenir permís del(s) titular(s) de drets.
Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	Prehabilitation ; Exercise capacity ; Chronic kidney disease ; Kidney transplant ; Frailty
Publicat a:	American Journal of Kidney Diseases, 2025 , ISSN 1523-6838

Disponible a partir de: 2099-01-01

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats