Can Solid-Organ-Transplanted Patients Perform a Cycling Marathon? Trends in Kidney Function Parameters in Comparison With Healthy Subjects

Background. Few solid-organ transplanted patients (TP) perform regular sport activity. Poor data are available on the safety of intense and prolonged physical exercise on this population. The aim of the study was to evaluate kidney function parameters in a group of TP in comparison with healthy volunteers (HV) involved in a long-distance road cycling race: length 130 km and total uphill gradient, 1871 m. Methods. Nineteen TP were recruited: 10 renal, 8 liver, and 1 heart and compared with 35 HV. Renal function parameters, namely, creatinine, estimated glomerular filtration rate (eGFR), urea, uric acid, urine specific gravity, microalbuminuria, and proteinuria were collected and their values were compared the day before the race (T1), immediately after crossing the finish line (T2), and 18 to 24 hours after the competition (T3). Results. No adverse events were recorded. At baseline, TP showed lower values of eGFR (69 +/- 22 versus 87 +/- 13 mL/min/1.73 m(2)), lower urine specific gravity (1015 +/- 4 versus 1019 +/- 6), and higher microalbuminuria (56 +/- 74 versus 8 +/- 15) and proteinuria values (166 +/- 99 versus 74 +/- 44) (in mg/L). At T2 in both groups, renal function parameters showed the same trends: decline of eGFR (54 +/- 19 versus 69 +/- 15 mL/min/1.73 m(2)) and rise in protein excretion. At T3, functional parameters returned to baseline, except for urine specific gravity values remaining stable in TP (1018 +/- 6) and growing higher in HV (1028 +/- 4). Conclusions. Selected and well-trained organ-transplanted patients can perform an intensive exercise, displaying temporary modifications on kidney function parameters comparable to healthy subjects, despite differences related to baseline clinical conditions and pharmacological therapies.