RESUMO
BACKGROUND: A few patients, after receiving solid organ transplantation, return to performing various sports and competitions; however, at present, data no study had evaluated the effects of endurance cycling races on their renal function. METHODS: Race times and short form (36) health survey questionnaires of 10 kidney transplant recipients (KTR) and 8 liver transplant recipients (LTR) transplanted recipients involved in a road cycling race (130 km) were compared with 35 healthy control subjects (HCS), also taking laboratory blood and urine tests the day before the race, at the end of the race, and 18 to 24 hours after competing. RESULTS: The 3 groups showed similar race times (KTR, 5 hours 59 minutes ± 0 hours 39 minutes; LTR, 6 hours 20 minutes ± 1 hour 11 minutes; HCS, 5 hours 40 minutes ± 1 hour 28 minutes), similar short form (36) health survey scores, and similar trend of laboratory parameters which returned to baseline after 18 to 24 hours. After the race, there was an increase in creatinine (0.24 mg/dL; effect size [ES] = 0.78; P < 0.001), urea (22 mg/dL; ES = 1.42; P < 0.001), and a decrease of estimated glomerular filtration rate (-17 mL/min; ES = 0.85; P < 0.001). The increase of blood uric acid was more remarkable in HCS and KTR (2.3 mg/dL; ES = 1.39; P < 0.001). The KTR showed an increase of microalbuminuria (167.4 mg/L; ES = 1.20; P < 0.001) and proteinuria (175 mg/mL; ES = 0.97; P < 0.001) similar to LTR (microalbuminuria: 176.0 mg/L; ES = 1.26; P < 0.001; proteinuria: 213 mg/mL; ES = 1.18; P < 0.001), with high individual variability. The HCS had a nonsignificant increase of microalbuminuria (4.4 mg/L; ES = 0.03; P = 0.338) and proteinuria (59 mg/mL; ES = 0.33; P = 0.084). CONCLUSIONS: Selected and well-trained KTR and LTR patients can participate to an endurance cycling race showing final race times and temporary modifications of kidney function similar to those of HCS group, despite some differences related to baseline clinical conditions and pharmacological therapies. Patients involved in this study represent the upper limit of performance currently available for transplant recipients and cannot be considered representative of the entire transplanted population.
RESUMO
BACKGROUND: Heart failure is one of the main causes of hospitalization in Italy. In some industrialized countries since the second half of 1990s a halt in the grow rate of hospitalization for this pathology has been observed, and in some cases a reversal. The aim of this study was to evaluate the trend of hospitalization for heart failure in Italy in the years 2001, 2002 and 2003. MATERIALS AND METHODS: National hospital discharge data for years 2001, 2002 and 2003 were analysed. RESULTS: Heart failure hospitalization increased from 193 042 in 2001 to 205 043 in 2002 (+6.2%) and to 211 183 in 2003 (+3% with respect to 2002). In 2003 heart failure was the primary medical cause of hospitalization (1.6%). Hospitalization for heart failure accounted in 2003 for 2% of global hospitalization costs. CONCLUSIONS: Heart failure is the primary cause of hospitalization in Italy and the rate of hospital admission from 2001 to 2003 continued to increase, as well as related costs. These data indicate the urgent need for implementation of new models for the management of heart failure, based on a healthcare network, including hospital, ambulatory and home care, potentially capable of ameliorating both quality of life and costs of assistance.
