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Relationship between pre‐transplant physical function and outcomes after kidney transplant
Author(s) -
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.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12952
Subject(s) - medicine , kidney transplant , balance (ability) , cohort , prospective cohort study , grip strength , gait , kidney transplantation , cohort study , physical therapy , transplantation
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.