title: Relationship between pre-transplant physical function and outcomes after kidney transplant.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.|William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.
authors.forename: Elizabeth C
authors.identifier: 0000-0003-1012-9409
authors.initials: EC
authors.lastname: Lorenz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Cheville
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.|William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.
authors.forename: Hatem
authors.initials: H
authors.lastname: Amer
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Kotajarvi
authors.affiliation: William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.|Division of Transplantation Surgery, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Stegall
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Petterson
authors.affiliation: William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.|Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Walter K
authors.initials: WK
authors.lastname: Kremers
authors.affiliation: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.|William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Cosio
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
authors.forename: Nathan K
authors.initials: NK
authors.lastname: LeBrasseur
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006304:Health Status; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D057234:Preoperative Period; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors
keywords: glomerular filtration rate (GFR); hospital readmission; kidney transplantation: living donor; quality of life (QOL)