A randomized, controlled, 12-month trial on the effects of an interdisciplinary treatment approach in ESRD patients: study protocol of the smart and fit for kidney transplantation trial (S&F4KTx)

Abstract Background A prolonged waiting time for a kidney transplant leads to a significant decline in the general health status of many patients with chronic kidney disease (CKD). This deterioration may cause these patients to be classified as unsuitable for transplantation during the waiting perio...

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Main Authors: Helge Krusemark, Judith Kleemann, Julian Weigand, Dennis Kannenkeril, Katharina Heller, Tobias Hepp, Marc Albersmeyer, Doris Gerbig, Mario Schiffer
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Trials
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Online Access:https://doi.org/10.1186/s13063-025-09022-2
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author Helge Krusemark
Judith Kleemann
Julian Weigand
Dennis Kannenkeril
Katharina Heller
Tobias Hepp
Marc Albersmeyer
Doris Gerbig
Mario Schiffer
author_facet Helge Krusemark
Judith Kleemann
Julian Weigand
Dennis Kannenkeril
Katharina Heller
Tobias Hepp
Marc Albersmeyer
Doris Gerbig
Mario Schiffer
author_sort Helge Krusemark
collection DOAJ
description Abstract Background A prolonged waiting time for a kidney transplant leads to a significant decline in the general health status of many patients with chronic kidney disease (CKD). This deterioration may cause these patients to be classified as unsuitable for transplantation during the waiting period owing to frailty, poor body composition, or the development of new comorbidities. Studies have shown that physical exercise and tailored nutrition can maintain and improve physical performance and overall health status. Methods This study is a 1:1 controlled, randomized trial. The control group will receive standard care along with an app designed for dialysis patients, which provides information on topics such as nutrition, vital signs, blood parameters, and details about their condition. In addition, the intervention group will receive individualized nutritional and exercise recommendations, along with a 3-week inpatient rehabilitation program. At 0, 6, and 12 months, body composition (body mass index, skeletal muscle mass, body fat mass, and waist circumference) and physical performance (6-min walk test, timed up and go test, sit-to-stand test, one-legged stance test, stair climbing test, and frailty), blood values (e.g., potassium and phosphate), and quality of life (KDQOL) will be evaluated. Bone density (tibia and radius) will be measured at 0 and 12 months. Discussion Studies have demonstrated that physical activity and tailored nutrition have positive effects on the general health of dialysis patients. However, pretransplantation preparation programs (prehabilitation) aimed at preserving transplant eligibility have not yet been evaluated. This study aims to address this gap by investigating a potential care program for patients on the transplant waiting list. Trial registration ClinicalTrials.gov NCT06040281. Registered on September 15, 2023. Trials status Protocol version number: 4 (30.07.2025). Recruitment start: 18.09.2023. Recruitment completed: 30.06.2025.
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spelling doaj-art-dba323db105e471db50d2b74a968ba9b2025-08-24T11:49:03ZengBMCTrials1745-62152025-08-012611910.1186/s13063-025-09022-2A randomized, controlled, 12-month trial on the effects of an interdisciplinary treatment approach in ESRD patients: study protocol of the smart and fit for kidney transplantation trial (S&F4KTx)Helge Krusemark0Judith Kleemann1Julian Weigand2Dennis Kannenkeril3Katharina Heller4Tobias Hepp5Marc Albersmeyer6Doris Gerbig7Mario Schiffer8Universitätsklinikum ErlangenUniversitätsklinikum ErlangenUniversitätsklinikum ErlangenUniversitätsklinikum ErlangenUniversitätsklinikum ErlangenFriedrich-Alexander-Universität Erlangen-NürnbergFachklinik Bad HeilbrunnFachklinik Bad HeilbrunnUniversitätsklinikum ErlangenAbstract Background A prolonged waiting time for a kidney transplant leads to a significant decline in the general health status of many patients with chronic kidney disease (CKD). This deterioration may cause these patients to be classified as unsuitable for transplantation during the waiting period owing to frailty, poor body composition, or the development of new comorbidities. Studies have shown that physical exercise and tailored nutrition can maintain and improve physical performance and overall health status. Methods This study is a 1:1 controlled, randomized trial. The control group will receive standard care along with an app designed for dialysis patients, which provides information on topics such as nutrition, vital signs, blood parameters, and details about their condition. In addition, the intervention group will receive individualized nutritional and exercise recommendations, along with a 3-week inpatient rehabilitation program. At 0, 6, and 12 months, body composition (body mass index, skeletal muscle mass, body fat mass, and waist circumference) and physical performance (6-min walk test, timed up and go test, sit-to-stand test, one-legged stance test, stair climbing test, and frailty), blood values (e.g., potassium and phosphate), and quality of life (KDQOL) will be evaluated. Bone density (tibia and radius) will be measured at 0 and 12 months. Discussion Studies have demonstrated that physical activity and tailored nutrition have positive effects on the general health of dialysis patients. However, pretransplantation preparation programs (prehabilitation) aimed at preserving transplant eligibility have not yet been evaluated. This study aims to address this gap by investigating a potential care program for patients on the transplant waiting list. Trial registration ClinicalTrials.gov NCT06040281. Registered on September 15, 2023. Trials status Protocol version number: 4 (30.07.2025). Recruitment start: 18.09.2023. Recruitment completed: 30.06.2025.https://doi.org/10.1186/s13063-025-09022-2PrehabilitationKidney transplantationExerciseNutritionEmpowermentFrailty
spellingShingle Helge Krusemark
Judith Kleemann
Julian Weigand
Dennis Kannenkeril
Katharina Heller
Tobias Hepp
Marc Albersmeyer
Doris Gerbig
Mario Schiffer
A randomized, controlled, 12-month trial on the effects of an interdisciplinary treatment approach in ESRD patients: study protocol of the smart and fit for kidney transplantation trial (S&F4KTx)
Trials
Prehabilitation
Kidney transplantation
Exercise
Nutrition
Empowerment
Frailty
title A randomized, controlled, 12-month trial on the effects of an interdisciplinary treatment approach in ESRD patients: study protocol of the smart and fit for kidney transplantation trial (S&F4KTx)
title_full A randomized, controlled, 12-month trial on the effects of an interdisciplinary treatment approach in ESRD patients: study protocol of the smart and fit for kidney transplantation trial (S&F4KTx)
title_fullStr A randomized, controlled, 12-month trial on the effects of an interdisciplinary treatment approach in ESRD patients: study protocol of the smart and fit for kidney transplantation trial (S&F4KTx)
title_full_unstemmed A randomized, controlled, 12-month trial on the effects of an interdisciplinary treatment approach in ESRD patients: study protocol of the smart and fit for kidney transplantation trial (S&F4KTx)
title_short A randomized, controlled, 12-month trial on the effects of an interdisciplinary treatment approach in ESRD patients: study protocol of the smart and fit for kidney transplantation trial (S&F4KTx)
title_sort randomized controlled 12 month trial on the effects of an interdisciplinary treatment approach in esrd patients study protocol of the smart and fit for kidney transplantation trial s f4ktx
topic Prehabilitation
Kidney transplantation
Exercise
Nutrition
Empowerment
Frailty
url https://doi.org/10.1186/s13063-025-09022-2
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