The self-paced 6MWT measures the distance walked in 6 minutes and predicts morbidity and mortality in patients with CVD and pulmonary disease. There are no data about the use of this simple, non-invasive test in the pre-transplant chronic kidney disease (CKD) population. 6MWT was done between 7/30/06 and 5/24/11 according to American Thoracic Society guidelines. Data were collected by patient survey and medical records. Prevalent CVD was defined as both coronary artery disease (CAD) and cerebrovascular disease. CAD was defined as history of chest pain, myocardial infarction or stenosis of a coronary artery by cardiac catheterization, percutaneous coronary intervention, or bypass grafting. Cerebrovascular disease was defined as a history of stroke or transient ischemic attack. Using a general linear model, the association of 6MWT distance with CVD was determined, univariately, and adjusting for age, gender, race, smoking status, body mass index (BMI), CKD stage, and diabetes. The difference in mean distance walked in meters between those with and those without CVD, CAD or cerebrovascular disease are reported. Among the 731 patients, mean (±SD) age was 55±11 years (range 21-84), 54% were male and 61% African American; 11% were current and 38% were prior smokers. BMI was 30±6 m². 76% were on dialysis, and CKD etiology was 57% diabetes. Average 6MWT was 318±136 meters (range 0-750). Among the CVD groups the difference in mean distance walked is summarized below.
|Groups (vs. those without)||N (%)||Univariate Difference in Mean||P value||Multivariate Difference in Mean||P value|
|All CVD||271 (37%)||52±10||<0.0001||37±10||0.0002|
|Any CAD||199 (27%)||35±11||0.0018||21±11||0.0462|
|Any Cerebrovascular Disease||116 (16%)||87±13||<0.0001||68±13||<0.0001|
Adjusted for CVD risk factors, there was a lower 6MWT performance among those with prevalent CVD that was strikingly diminished among those with cerebrovascular disease. These findings are consistent with studies in other patient populations indicating that exercise capacity predicts the presence of CVD. Further studies are needed to determine if 6MWT can help risk stratify pre-transplant CKD patients for subsequent transplant related outcomes and whether improving exercise performance results in improved outcomes.
To cite this abstract in AMA style:Stewart H, Kshirsagar A, Hinderliter A, Detwiler R, Hu Y, Hogan S. Association of the Six-Minute Walk Test (6MWT) with Prevalent Cardiovascular Disease (CVD) in a Renal Transplant Evaluation Clinic, The [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/association-of-the-six-minute-walk-test-6mwt-with-prevalent-cardiovascular-disease-cvd-in-a-renal-transplant-evaluation-clinic-the/. Accessed June 13, 2021.
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