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

Clin Transplant. 2017 May;31(5):10.1111/ctr.12952. doi: 10.1111/ctr.12952. Epub 2017 Apr 17.

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).

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Health Status*
  • Humans
  • Kidney Failure, Chronic / surgery*
  • Kidney Function Tests
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Physical Fitness
  • Preoperative Period
  • Prognosis
  • Prospective Studies
  • Quality of Life*
  • Risk Factors