Relationship between pre-transplant physical function and outcomes after kidney transplant

Elizabeth C. Lorenz, Andrea L Cheville, Hatem Amer, Brian R. Kotajarvi, Mark D Stegall, Tanya M. Petterson, Walter K Kremers, Fernando G Cosio, Nathan K LeBrasseur

Research output: Contribution to journalArticle

11 Scopus citations

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.

Original languageEnglish (US)
Article numbere12952
JournalClinical Transplantation
Volume31
Issue number5
DOIs
StatePublished - May 1 2017

    Fingerprint

Keywords

  • glomerular filtration rate (GFR)
  • hospital readmission
  • kidney transplantation: living donor
  • quality of life (QOL)

ASJC Scopus subject areas

  • Transplantation

Cite this