Assessment of physical performance and quality of life in kidney-transplanted patients: a cross-sectional study

Pasquale Esposito; Francesco Furini; Teresa Rampino; Marilena Gregorini; Lucia Petrucci; Catherine Klersy; Antonio Dal Canton; Elena Dalla Toffola

doi:10.1093/ckj/sfw102

Assessment of physical performance and quality of life in kidney-transplanted patients: a cross-sectional study

Clin Kidney J. 2017 Feb;10(1):124-130. doi: 10.1093/ckj/sfw102. Epub 2016 Nov 10.

Authors

Pasquale Esposito¹, Francesco Furini², Teresa Rampino¹, Marilena Gregorini¹, Lucia Petrucci², Catherine Klersy³, Antonio Dal Canton¹, Elena Dalla Toffola²

Affiliations

¹ Department of Nephrology, Dialysis and Transplantation, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Viale Golgi 19, 27100 Pavia, Italy.
² Rehabilitation Unit, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy.
³ Service of Biometry and Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo of Pavia, Pavia, Italy.

Abstract

Background: Information on physical and mental wellness in renal transplantation is limited. Therefore, we performed a cross-sectional study to evaluate and describe the different components of physical performance and quality of life (QoL) in a cohort of kidney-transplanted patients.

Methods: Physical performance and QoL were determined through the administration of validated tests and questionnaires [muscle strength, dynamometer handgrip, tactile sensitivity, visual analogue scale (VAS) for pain, Timed Up and Go (TUG) test, Fatigue Severity Scale (FSS) and the 36-item Short Form Health Survey]. The patients were divided into three groups based on time elapsed since transplantation: early (in the first 6 months), middle (from 7 to 60 months) and late (>60 months).

Results: Of 132 enrolled patients, 11 patients (8.3%) presented a severe reduction of muscle strength, 63 patients (47%) had significant bilateral impaired handgrip and tactile sensitivity was altered in 23 patients (17.4%). TUG assessment showed significant mobility limitation in 29 patients (21.9%). The FSS presented a pathological value in 50 patients (37.3%), while the mean VAS was 1.8 ± 2.7. There were no significant differences in physical performance parameters among the three patient groups. There were inverse correlations among different components of physical performance and age, comorbidity and dialysis vintage, and there was a direct correlation with renal function. During the first months after transplantation there were limitations in physical, social and emotional activities. Overall, the self-perceived physical performance was significantly lower in transplanted patients with respect to the normal reference level.

Conclusion: Kidney-transplanted patients may present different degrees of impairment in physical performance and quality of life. Systematic functional assessment is essential to identify patients needing intensive and personalized rehabilitation programmes.

Keywords: kidney transplantation; physical and rehabilitation medicine; quality of life.