Background: Across all medical specialties, frailty has been shown to be a predictor of poor health outcomes. Previous studies have shown that gait speed and grip strength can be utilized as objective measures of frailty and can predict poor outcomes in many chronic disease states. The aims of the present study were to examine the association between gait speed and grip strength and renal transplant candidacy outcomes.

Methods: A retrospective medical chart review was performed and consecutive patients undergoing evaluation for renal transplant between 02/2005 to 10/2014 were included in the present study. Gait speed was measured using a 5 Meter-Walk Test and isometric dominant hand grip strength was measured using a dynamometer. Based on the distribution of data, analyses included Mann Whitney U tests and Analysis of Variance. Cox regression was employed to test predictors of survival.

Results: A total of 341 renal transplant candidates were tested with regard to gait speed and grip strength. The mean age was 58.2 years (SD=11.9); 60% were male, and 73% were Caucasian. Mean gait speed was 0.912 meters per second (m/s) (SD=0.218) and median grip strength of the dominant hand was 46.67 kg (SD=23.3). Patients who were listed for transplant were found to have a faster gait speed (Mean=0.946; SD=0.213) compared to patients not listed for transplant (Mean=0.880; SD=0.219); [F (1,319)=0.091, p=0.006]. Listed patients were also found to have a stronger median dominant hand grip strength 46.67kg (IQR=25.8) when compared to those who were not listed (Median=43.3 kg, IQR=24.5); [Mann Whitney U=8865, p=0.016]. Amongst all patients, faster gait speed significantly predicted survival in univariate analyses [c²=5.526, b=-1.096, p=0.019]. After adjusting for sex, race, history of cerebral vascular accidents and peripheral vascular disease, faster gait speed remained an independent predictor of better overall survival [c²=9.027, b=-0.986, p=0.05].

Conclusions: Measures of frailty such as gait speed and grip strength are important predictors of waitlist candidacy and survival. Interventions to decrease to improve physical fitness and strength should be considered for patients diagnosed with end stage renal disease being referred for or awaiting renal transplant.

CITATION INFORMATION: Tevar A., Lemon K., Wu C., Shah N., Mehta R., Puttarajappa C., Sood P., Hariharan S., Ganoza A., Wijkstrom M., Molinari M., Humar A., Wang Y., Steel J. Objective Markers of Frailty Predict Successful Listing and Survival for Renal Transplant Am J Transplant. 2017;17 (suppl 3).

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