Pre-Kidney Transplant Lower Extremity Impairment and Post-Transplant Mortality.

A. Nastasi,^1,2 M. McAdams-DeMarco,^1,2 J. Schrack,¹ H. Ying,² C. Haugen,² M. González Fernández,³ D. Segev.^1,2

¹Epidemiology, Johns Hopkins University, Baltimore, MD
²Surgery, Johns Hopkins University, Baltimore, MD
³Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD

Meeting: 2017 American Transplant Congress

Abstract number: D297

Keywords: Age factors, Elderly patients, Kidney transplantation, Mortality

Session Information

Session Name: Poster Session D: Non-Organ Specific: Economics, Public Policy, Allocation, Ethics

Session Type: Poster Session

Date: Tuesday, May 2, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

INTRODUCTION. Few objective tests can be easily performed prior to kidney transplantation (KT) to effectively stratify patients by risk of post-KT mortality. The short physical performance battery (SPPB) is an easily administered test of lower extremity function consisting of three parts (balance, walking speed, chair stands) each with scores of 0-4 for a composite score of 0-12 with higher scores indicating better function. The SPPB was developed among community-dwelling older adults without ESRD, but may be useful to quantify the accelerated aging associated with ESRD among KT recipients.

METHODS. The SPPB was administered pre-KT in a prospective cohort of 652 KT recipients at Johns Hopkins Hospital (8/2009-6/2016). The associations between SPPB and post-KT mortality were tested using adjusted Cox proportional hazards models.

RESULTS. The 5-year post-KT mortality for impaired (SPPB≤10) recipients was 21.6% compared to 7.2% for unimpaired recipients (P=0.001). Impaired recipients had twice (adjusted HR: 2.14, 95%CI: 1.12–4.09, P=0.02) the risk of post-KT mortality. Each one-point increase in SPPB score was associated with a 12% (adjusted HR: 0.88, 95%CI:0.78–0.99, P=0.03) lower risk of post-KT mortality.

CONCLUSIONS. Lower extremity impairment measured by SPPB is potentially a highly useful, objective tool for pre-KT risk stratification.

CITATION INFORMATION: Nastasi A, McAdams-DeMarco M, Schrack J, Ying H, Haugen C, González Fernández M, Segev D. Pre-Kidney Transplant Lower Extremity Impairment and Post-Transplant Mortality. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Nastasi A, McAdams-DeMarco M, Schrack J, Ying H, Haugen C, Fernández MGonzález, Segev D. Pre-Kidney Transplant Lower Extremity Impairment and Post-Transplant Mortality. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/pre-kidney-transplant-lower-extremity-impairment-and-post-transplant-mortality/. Accessed May 17, 2025.

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