BACKGROUND: Frailty and decreased functional status are risk factors for adverse kidney transplant (KT) outcomes. Our objective was to examine the efficacy of an exercise intervention on frailty and decreased functional status in a cohort of patients with advanced chronic kidney disease (CKD). METHODS: We conducted a prospective study involving 21 adults with ≥stage 4 CKD who were (a) frail or pre-frail by Fried phenotype and/or (b) had lower extremity impairment [short physical performance battery score ≤10]. The intervention consisted of two supervised outpatient exercise sessions per week for 8 weeks. RESULTS: Among our cohort, median participant age was 62 years (interquartile range, 53-67) and 85.7% had been evaluated for KT. Following the study, participants reported satisfaction with the intervention and multiple frailty parameters improved significantly, including fatigue, physical activity, walking time, and grip strength. Lower extremity impairment also improved (90.5%-61.9%, P = .03). No study-related adverse events occurred. CONCLUSIONS: Preliminary data from this study suggest that a supervised, outpatient exercise intervention is safe, acceptable, feasible, and associated with improved frailty parameters, and lower extremity function, in patients with advanced CKD. Further studies are needed to confirm these findings and determine whether this prehabilitation strategy improves KT outcomes.
BACKGROUND: Frailty and decreased functional status are risk factors for adverse kidney transplant (KT) outcomes. Our objective was to examine the efficacy of an exercise intervention on frailty and decreased functional status in a cohort of patients with advanced chronic kidney disease (CKD). METHODS: We conducted a prospective study involving 21 adults with ≥stage 4 CKD who were (a) frail or pre-frail by Fried phenotype and/or (b) had lower extremity impairment [short physical performance battery score ≤10]. The intervention consisted of two supervised outpatient exercise sessions per week for 8 weeks. RESULTS: Among our cohort, median participant age was 62 years (interquartile range, 53-67) and 85.7% had been evaluated for KT. Following the study, participants reported satisfaction with the intervention and multiple frailty parameters improved significantly, including fatigue, physical activity, walking time, and grip strength. Lower extremity impairment also improved (90.5%-61.9%, P = .03). No study-related adverse events occurred. CONCLUSIONS: Preliminary data from this study suggest that a supervised, outpatient exercise intervention is safe, acceptable, feasible, and associated with improved frailty parameters, and lower extremity function, in patients with advanced CKD. Further studies are needed to confirm these findings and determine whether this prehabilitation strategy improves KT outcomes.
Authors: Carolyn L Rochester; Ioannis Vogiatzis; Anne E Holland; Suzanne C Lareau; Darcy D Marciniuk; Milo A Puhan; Martijn A Spruit; Sarah Masefield; Richard Casaburi; Enrico M Clini; Rebecca Crouch; Judith Garcia-Aymerich; Chris Garvey; Roger S Goldstein; Kylie Hill; Michael Morgan; Linda Nici; Fabio Pitta; Andrew L Ries; Sally J Singh; Thierry Troosters; Peter J Wijkstra; Barbara P Yawn; Richard L ZuWallack Journal: Am J Respir Crit Care Med Date: 2015-12-01 Impact factor: 21.405
Authors: Alvin Thomas; Christine E Haugen; Alexandra Mountford; Fatima Warsame; Rachel Berkowitz; Sunjae Bae; Charles H Brown; Daniel C Brennan; Karin J Neufeld; Michelle C Carlson; Dorry L Segev; Mara McAdams-DeMarco Journal: J Am Soc Nephrol Date: 2018-04-23 Impact factor: 10.121
Authors: Elizabeth C Lorenz; Andrea L Cheville; Hatem Amer; Brian R Kotajarvi; Mark D Stegall; Tanya M Petterson; Walter K Kremers; Fernando G Cosio; Nathan K LeBrasseur Journal: Clin Transplant Date: 2017-04-17 Impact factor: 2.863
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: Mara A McAdams-DeMarco; Israel O Olorundare; Hao Ying; Fatima Warsame; Christine E Haugen; Rasheeda Hall; Jacqueline M Garonzik-Wang; Niraj M Desai; Jeremy D Walston; Silas P Norman; Dorry L Segev Journal: Transplantation Date: 2018-02 Impact factor: 4.939
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