BACKGROUND: The short physical performance battery (SPPB) test is an objective measurement of lower extremity function (walk speed, balance, chair stands). SPPB impairment is associated with longer length of stay and increased mortality in kidney transplant (KT) recipients. Furthermore, the SPPB test may represent an objective quantification of the "foot of the bed test" utilized by clinicians; therefore, impairment may translate with decreased access to KT. METHODS: We studied 3255 participants (2009-2018) at 2 KT centers. SPPB impairment was defined as a score of ≤10. We estimated time to listing, waitlist mortality, and transplant rate by SPPB impairment status using Cox proportional hazards, competing risks, and Poisson regression. RESULTS: The mean age was 54 years (SD = 14; range 18-89) and 54% had SPPB impairment. Impaired participants were less likely to be listed for KT (adjusted hazard ratio: 0.70, 95% CI: 0.64-0.77, P < 0.001). Also, once listed, impaired candidates had a 1.6-fold increased risk of waitlist mortality (adjusted subhazard ratio: 1.56, 95% CI: 1.18-2.06, P = 0.002). Furthermore, impaired candidates were transplanted 16% less frequently (adjusted incidence rate ratio: 0.84, 95% CI: 0.73-0.98, P = 0.02). CONCLUSIONS: SPPB impairment was highly prevalent in KT candidates. Impaired candidates had decreased chance of listing, increased risk of waitlist mortality, and decreased rate of KT. Identification of robust KT candidates and improvement in lower extremity function are potential ways to improve survival on the waitlist and access to KT.
BACKGROUND: The short physical performance battery (SPPB) test is an objective measurement of lower extremity function (walk speed, balance, chair stands). SPPB impairment is associated with longer length of stay and increased mortality in kidney transplant (KT) recipients. Furthermore, the SPPB test may represent an objective quantification of the "foot of the bed test" utilized by clinicians; therefore, impairment may translate with decreased access to KT. METHODS: We studied 3255 participants (2009-2018) at 2 KT centers. SPPB impairment was defined as a score of ≤10. We estimated time to listing, waitlist mortality, and transplant rate by SPPB impairment status using Cox proportional hazards, competing risks, and Poisson regression. RESULTS: The mean age was 54 years (SD = 14; range 18-89) and 54% had SPPB impairment. Impaired participants were less likely to be listed for KT (adjusted hazard ratio: 0.70, 95% CI: 0.64-0.77, P < 0.001). Also, once listed, impaired candidates had a 1.6-fold increased risk of waitlist mortality (adjusted subhazard ratio: 1.56, 95% CI: 1.18-2.06, P = 0.002). Furthermore, impaired candidates were transplanted 16% less frequently (adjusted incidence rate ratio: 0.84, 95% CI: 0.73-0.98, P = 0.02). CONCLUSIONS: SPPB impairment was highly prevalent in KT candidates. Impaired candidates had decreased chance of listing, increased risk of waitlist mortality, and decreased rate of KT. Identification of robust KT candidates and improvement in lower extremity function are potential ways to improve survival on the waitlist and access to KT.
Authors: George A Kaysen; Brett Larive; Patricia Painter; Alexander Craig; Robert M Lindsay; Michael V Rocco; John T Daugirdas; Gerald Schulman; Glenn M Chertow Journal: Am J Kidney Dis Date: 2011-01 Impact factor: 8.860
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Mara A McAdams-DeMarco; Hao Ying; Israel Olorundare; Elizabeth A King; Christine Haugen; Brian Buta; Alden L Gross; Rita Kalyani; Niraj M Desai; Nabil N Dagher; Bonnie E Lonze; Robert A Montgomery; Karen Bandeen-Roche; Jeremy D Walston; Dorry L Segev Journal: Transplantation Date: 2017-09 Impact factor: 4.939
Authors: M A McAdams-DeMarco; A Law; E King; B Orandi; M Salter; N Gupta; E Chow; N Alachkar; N Desai; R Varadhan; J Walston; D L Segev Journal: Am J Transplant Date: 2014-10-30 Impact factor: 8.086
Authors: Rita Pavasini; Jack Guralnik; Justin C Brown; Mauro di Bari; Matteo Cesari; Francesco Landi; Bert Vaes; Delphine Legrand; Joe Verghese; Cuiling Wang; Sari Stenholm; Luigi Ferrucci; Jennifer C Lai; Anna Arnau Bartes; Joan Espaulella; Montserrat Ferrer; Jae-Young Lim; Kristine E Ensrud; Peggy Cawthon; Anna Turusheva; Elena Frolova; Yves Rolland; Valerie Lauwers; Andrea Corsonello; Gregory D Kirk; Roberto Ferrari; Stefano Volpato; Gianluca Campo Journal: BMC Med Date: 2016-12-22 Impact factor: 8.775
Authors: Mara A McAdams-DeMarco; Andrew Law; Megan L Salter; Brian Boyarsky; Luis Gimenez; Bernard G Jaar; Jeremy D Walston; Dorry L Segev Journal: J Am Geriatr Soc Date: 2013-05-27 Impact factor: 7.538
Authors: Mara A McAdams-DeMarco; Sunitha Suresh; Andrew Law; Megan L Salter; Luis F Gimenez; Bernard G Jaar; Jeremy D Walston; Dorry L Segev Journal: BMC Nephrol Date: 2013-10-16 Impact factor: 2.388
Authors: Elizabeth C Lorenz; LaTonya J Hickson; Renee M Weatherly; Karin L Thompson; Heidi A Walker; Judy M Rasmussen; Tara L Stewart; James K Garrett; Hatem Amer; Cassie C Kennedy Journal: Clin Transplant Date: 2020-07-24 Impact factor: 2.863
Authors: Jesse D Schold; Joshua J Augustine; Anne M Huml; John O'Toole; John R Sedor; Emilio D Poggio Journal: Am J Transplant Date: 2019-11-15 Impact factor: 8.086
Authors: Xiaomeng Chen; Nadia M Chu; Pragyashree Sharma Basyal; Wasurut Vihokrut; Deidra Crews; Daniel C Brennan; Sarah R Andrews; Tracy D Vannorsdall; Dorry L Segev; Mara A McAdams-DeMarco Journal: Kidney Int Rep Date: 2022-03-15
Authors: Xingxing S Cheng; Jonathan Myers; Jialin Han; Margaret R Stedman; Daniel J Watford; Jenny Lee; Kevin V Discipulo; Khin N Chan; Glenn M Chertow; Jane C Tan Journal: Am J Kidney Dis Date: 2020-06-06 Impact factor: 8.860
Authors: Elizabeth C Lorenz; Cassie C Kennedy; Andrew D Rule; Nathan K LeBrasseur; James L Kirkland; LaTonya J Hickson Journal: Kidney Int Rep Date: 2021-06-09