Abstract: TH-PO1135
Evaluation of Functional and Nutrition Status in the Older Transplant Candidate
Session Information
- Transplantation: Clinical - Pretransplant Management
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Moss, Olivia A., UC Davis Health, Sacramento, California, United States
- Friedman, Golnaz G., UC Davis Health, Sacramento, California, United States
- Yerraguntala, Anusha S., UC Davis, Davis, California, United States
- Sockolov, Macey, UC Davis Health, Sacramento, California, United States
- Chen, Ling-Xin, UC Davis Health, Sacramento, California, United States
Background
Measures of functional and nutrition status (NS) at time of kidney transplant (KT) have been shown to be predictive of post-KT outcomes. No gold standard tool to best assess functional status exists. Assessment of physiological reserve is important in the older KT candidate who may have additional risk factors such as malnutrition. Our purpose is to identify the functional and NS measures predictive of ineligibility for KT listing.
Methods
All patients >65 years old evaluated for KT were recruited. Participants completed the short physical performance battery (SPPB) and Fried Frailty assessment (FFA). Nutrition status was assessed using standardized malnutrition criteria. Patient charts were reviewed for KT listing status (ineligible or listed). Differences between SPPB, FFA, NS, and the components of each assessment were tested between groups by ANOVA, Chi-squared and logistic regression analyses.
Results
A total of 105 patients were enrolled and 73 had complete follow-up data at time of analysis. Scores for the SPPB and FFA were not predictive of ineligibility of KT listing [Table 1]. However, slower chair stand time (OR 1.051.281.55, p=0.01) and slower walk time (OR 1.112.375.10 , p=0.03) were predictive of KT ineligibility. Those ineligible for KT tended to report lower physical activity levels, have lower handgrip strength and be malnourished compared to those who were listed, but this did not reach significance [Table 1].
Conclusion
Objective measures like walk and chair stand time may be more predictive of KT ineligibility than SPPB and FFA when used at the time of KT candidacy evaluation, but further investigations are needed.
Table 1
| All N=105 | Ineligible N=48 | Listed N=25 | |
| SPPB score | 9.8 (1.6) | 9.7 (1.5) | 10.3 (1.8) |
| Balance score | 3.6 (0.8) | 3.6 (0.7) | 3.6 (0.8) |
| Walk time, sec | 4.1 (0.9) | 4.1 (0.9) | 3.9 (0.7) |
| Chair stand time*, sec | 14.0 (3.5) | 14.6 (3.7) | 12.0 (2.9) |
| FFA score | 1.1 (1.0) | 1.2 (1.0) | 0.8 (1.0) |
| Weight change, lbs | -1.8 (6.9) | -2.6 (7.6) | 0.85 (4.7) |
| Energy scale | 6.8 (1.6) | 6.6 (1.5) | 7.0 (1.8) |
| Energy expenditure, kcal/week | 1257 (1696) | 1308 (2035) | 1551 (1632) |
| Hand grip strength, kg | 27.4 (10.2) | 27.2 (9.6) | 30.2 (12.6) |
| Walk time, sec | 4.2 (0.9) | 4.4 (1.0) | 3.9 (0.7) |
| Malnutrition | 13 (12) | 7 (15) | 2 (8) |
All values reported as mean (SD) except for malnutrition, n ( %), *p=0.009
Funding
- Private Foundation Support