Changes in peak oxygen uptake (VO_2peak) following renal transplant: Results after 3-year follow-up

Peak oxygen uptake (VO₂peak) is an important predictor of cardiovascular and all-cause mortality in patients with renal disease. VO₂peak worsens in patients with chronic renal disease and has been reported to improve in the short term (6-month time period) following renal transplant. However, long-term changes in VO₂peak following renal transplant remain uncharacterized. We examined changes in VO₂peak over ~3 years of follow-up after renal transplant in 18 patients (age—56.2 ± 2.5 years, BMI—29.7 ± 6). VO₂peak was quantified using a treadmill ramp test prior to and following renal transplantation. Subjects were classified as stable vs adverse responders based on changes in VO₂peak on follow-up. Relative VO₂peak declined significantly from 15.2 ± 0.8 mL/kg/min to 12.2 ± 0.4 mL/kg/min (~20% reduction) in the entire cohort principally driven by reductions in the adverse response group (n = 10; pre—16.5 ± 1.1, post—11.9 ± 0.5 mL/kg/min) that had greater reductions in VO₂peak compared with the stable group (n = 8; pre—13.7 ± 0.7, post—12.5 ± 0.7 mL/kg/min). There were significantly greater hospitalizations in the adverse response group as well. The trends demonstrated in our exploratory study of 18 patients need to be examined and validated in larger cohorts.