Relationship between pre‐transplant physical function and outcomes after kidney transplant. Issue 5 (17th April 2017)

• Record Type: Journal Article
• Authors: Lorenz, Elizabeth C.; Cheville, Andrea L.; Amer, Hatem; Kotajarvi, Brian R.; Stegall, Mark D.; Petterson, Tanya M.; Kremers, Walter K.; Cosio, Fernando G.; LeBrasseur, Nathan K.
• Is Part Of: Clinical transplantation. Volume 31:Issue 5(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-04-17
• Subjects: glomerular filtration rate (GFR) -- hospital readmission -- kidney transplantation: living donor -- quality of life (QOL); Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12952
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background: Performance‐based measures of physical function predict morbidity following non‐transplant surgery. Study objectives were to determine whether physical function predicts outcomes after kidney transplant and assess how physical function changes post‐transplant. Methods: We conducted a prospective study involving living donor kidney transplants recipients at our center from May 2012 to February 2014. Physical function was measured using the Short Physical Performance Battery (SPPB [balance, chair stands, gait speed]) and grip strength testing. Initial length of stay (LOS), 30‐ day rehospitalizations, allograft function, and quality of life (QOL) were assessed. Results: The majority of the 140 patients in our cohort had excellent pre‐transplant physical function. In general, balance scores were more predictive of post‐transplant outcomes than the SPPB. Decreased pre‐transplant balance was independently associated with longer LOS and increased rehospitalizations but not with post‐transplant QOL; 35% of patients experienced a clinically meaningful (≥ 1.0 m/s) improvement in gait speed 4 months post‐transplant. Conclusions: Decreased physical function may be associated with longer LOS and rehospitalizations following kidney transplant. Further studies are needed to confirm this association. The lack of relationship between pre‐transplant gait speed and outcomes in our cohort may represent a ceiling effect. More comprehensive measures, including balance testing, may be required for risk stratification.