#3030 FEASIBILITY OF HOME-BASED EXERCISE IN KIDNEY TRANSPLANT RECIPIENTS: PARTICIPANT CHARACTERISTICS AND INITIAL RESULTS FROM THE ECSERT TRIAL
Authors: Billany Roseanne E , Mubaarak Zahra , Burns Stephanie , Young Hannah , Bishop Nicolette , Smith Alice , Graham-Brown Matthew 
Published: June 2023

Abstract

Background and Aims
Kidney transplant recipients (KTR) are prone to high rates of infection, malignancy and cardiovascular disease. Poor physical fitness and physical inactivity remain pertinent targets to improve post-transplant clinical outcomes. Only 27% of KTR are classified as physically active for health. The ECSERT pilot randomised controlled trial aims to assess the feasibility of delivering a structured, home-based exercise intervention in 50 KTR at increased cardiometabolic risk and evaluated the putative effects on cardiovascular structure and function, cardiorespiratory fitness, physical function, quality of life, metabolic and inflammatory markers. We present interim feasibility data describing engagement with the home-based programme of exercise for all patients who have completed the programme to date.

Method
Potential KTRs were screened for eligibility and approached by their consultant nephrologist, and if interested, further study details were explained by a researcher. Those who consented to take part were randomised (1:1) to either a 12-week structured home-based exercise programme (INT, n = 22) or 12-week usual care control (CTR, n = 23). Figure 1 outlines the home-based exercise programme. The a priori thresholds for specific feasibility and acceptability criteria are as follows: recruitment success of 20% of eligible participants (≥2 participants per month), adherence (an average of three exercise sessions per week) and attrition (≤30%).

Results
Ninety patients were approached and 45 (50%) recruited across 22 months of recruitment (currently ongoing). Participant characteristics were: 50±14 years (INT 48±13; CTR 52±15), 21 male (INT 8; CTR 13), eGFR 59±19 ml/min/1.73 m2 (INT 62±19; CTR 58±19), 31 White British (WB) and 14 Asian ethnicity (INT 14 WB, 8 Asian; CNR 17 WB, 6 Asian). Two participants withdrew from the intervention group (1 due to COVID-19 infection, 1 due to recurrent urine infections unrelated to the trial) and one from the control group (lost to follow-up; 7.3% attrition). There were no adverse events reported related to the exercise intervention or trial procedures. Intervention participants (n = 16 completed) recorded an average of 4.5±1.4 exercise sessions per week (aerobic 2.9±1.2; strength 1.6±0.4). Completion of key baseline outcome measures was: cardiac MRI scan 95%, cardiopulmonary exercise test 88%, accelerometry 100%, physical function 100%, body composition 100%, blood sampling 100% and questionnaire packs 97.6%.

Conclusion
Results suggest engagement with the home-based exercise programme in KTRs is excellent. The study is comfortably exceeding a priori thresholds relating to recruitment, retention and completion suggesting patients are interested in the study and the programme of exercise despite the current evidence showing physical activity levels are low. The groups are well matched and there is encouraging representation of female participants and participants from a non-white background. These initial results support study continuation and further assessment and development of home-based programmes of exercise and activity for KTR.