Low physical activity increases kidney transplant patients' likelihood（可能） of dying early, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). The results suggest that patients need to exercise to fend¹ off（避开） an early death. Inactive people in general face increased risks of developing cardiovascular disease（心血管疾病） and of dying prematurely³. Individuals with chronic⁴ kidney disease—particularly those on dialysis（透析） —tend to get little exercise, but most increase their activity levels modestly after receiving a kidney transplant. Until now, no one has examined whether low physical activity levels in kidney transplant recipients⁵ is associated with an increased risk of dying prematurely from heart-related or other causes. Maintaining heart health is particularly important for these individuals, as kidney transplant recipients have a 4- to 6-fold increased risk of dying from cardiovascular causes than individuals in the general population.

Dorien Zelle (University Medical Center Groningen, in the Netherlands) and her colleagues studied the health of 540 kidney transplant recipients between 2001 and 2003, assessing physical activity through questionnaires and recording⁶ deaths until August 2007. With regard to the guidelines for minimum requirements of physical activity, 260 (48%) patients did not meet the criteria⁷（标准，条件） and 79 (14.6%) were completely inactive.

During the study period, 81 patients died, with 37 heart-related deaths; the lower the level of physical activity, the higher the rate of deaths. Specifically, cardiovascular deaths occurred in 11.7%, 7.2%, and 1.7% of patients considered inactive, moderately active, and active, respectively. Deaths from any cause occurred at rates of 24.4%, 15.0%, and 5.6% in these respective groups.

The investigators⁸ acknowledged that in general, sicker people are less likely to exercise and more likely to die; however, they found that the link between low physical activity and premature² death was not substantially affected⁹ by adjustments（调整） for factors such as patients' heart health, kidney function, muscle mass, and their diabetes¹⁰ and smoking status.

Dr. Zelle noted¹¹ that to determine whether increased physical activity levels may improve the health and prolong（拖延） the lives of transplant recipients, the University Medical Center Groningen, in collaboration¹² with the University Medical Center Maastricht, will start a randomized controlled lifestyle intervention¹³ study. Kidney transplant recipients will undergo（经历，感受） a supervised exercise program and receive individual counseling to promote physical activity and a healthy diet.