Relationship between pre‐transplant physical function and outcomes after kidney transplant
EC Lorenz, AL Cheville, H Amer… - Clinical …, 2017 - Wiley Online Library
EC Lorenz, AL Cheville, H Amer, BR Kotajarvi, MD Stegall, TM Petterson, WK Kremers…
Clinical transplantation, 2017•Wiley Online LibraryBackground 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 …
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 …
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.
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