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

8 Citations (Scopus)

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

Transplants
Kidney
Length of Stay
Quality of Life
Living Donors
Hand Strength
Allografts
Prospective Studies
Morbidity
Walking Speed

Keywords

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

ASJC Scopus subject areas

  • Transplantation

Cite this

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

In: Clinical Transplantation, Vol. 31, No. 5, e12952, 01.05.2017.

Research output: Contribution to journalArticle

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. / Relationship between pre-transplant physical function and outcomes after kidney transplant. In: Clinical Transplantation. 2017 ; Vol. 31, No. 5.
@article{9a8bfadb08fd46cc8e598b3fc0dee0d1,
title = "Relationship between pre-transplant physical function and outcomes after kidney transplant",
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.",
keywords = "glomerular filtration rate (GFR), hospital readmission, kidney transplantation: living donor, quality of life (QOL)",
author = "Lorenz, {Elizabeth C.} and Cheville, {Andrea L} and Hatem Amer and Kotajarvi, {Brian R.} and Stegall, {Mark D} and Petterson, {Tanya M.} and Kremers, {Walter K} and Cosio, {Fernando G} and LeBrasseur, {Nathan K}",
year = "2017",
month = "5",
day = "1",
doi = "10.1111/ctr.12952",
language = "English (US)",
volume = "31",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Relationship between pre-transplant physical function and outcomes after kidney transplant

AU - Lorenz, Elizabeth C.

AU - Cheville, Andrea L

AU - Amer, Hatem

AU - Kotajarvi, Brian R.

AU - Stegall, Mark D

AU - Petterson, Tanya M.

AU - Kremers, Walter K

AU - Cosio, Fernando G

AU - LeBrasseur, Nathan K

PY - 2017/5/1

Y1 - 2017/5/1

N2 - 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.

AB - 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.

KW - glomerular filtration rate (GFR)

KW - hospital readmission

KW - kidney transplantation: living donor

KW - quality of life (QOL)

UR - http://www.scopus.com/inward/record.url?scp=85017571539&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017571539&partnerID=8YFLogxK

U2 - 10.1111/ctr.12952

DO - 10.1111/ctr.12952

M3 - Article

C2 - 28295612

AN - SCOPUS:85017571539

VL - 31

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 5

M1 - e12952

ER -