Predictive Value of Functional and Nutrition Status in Older Transplant Candidates

Washington, DC—Outcomes following kidney transplantation may be predicted by measures of functional and nutrition status at the time of the transplantation. There is no gold standard tool to optimally assess functional status. In older kidney transplant candidates, assessment of physiological reserve is particularly important, due to the possibility of the presence of additional risk factors such as malnutrition.

During a poster session at Kidney Week 2019, Olivia A. Moss, MS, RD, and colleagues at UC Davis Health, Sacramento, California, reported results of a study designed to identify the functional and nutrition status measures predictive of ineligibility for kidney transplant listing. The poster was titled Evaluation of Functional and Nutrition Status in the Older Transplant Candidate.

Patients >65 years of age who were evaluated for kidney transplant were recruited for the study. Participants completed the short physical performance battery (SPPB) and the Fried Frailty assessment (FFA). Standardized malnutrition criteria were used to assess nutrition status. Patients charts were reviewed to ascertain kidney transplant listing status (ineligible or listed). ANOVA, Chi-square and logistic regression analyses were used to test differences between the two groups in SPPB, FFA, nutrition status, and the components of each assessment.

Of the 105 participants enrolled, 73 had complete follow-up data at the time of the analysis. Scores for the SPPB and the FFA did not predict ineligibility or kidney transplant listing. However, slower chair stand time and slower walk time were predictive of kidney transplant ineligibility.

Participants in the ineligible group tended to report lower levels of physical activity, have lower handgrip strength, and were malnourished, compared with those who were listed for transplant. This difference did not reach statistical significance.

“Objective measures like walk and chair stand time may be more predictive of kidney transplant ineligibility than SPPB and FFA when used at the time of kidney transplant candidacy evaluation, but further investigations are needed,” the researchers said.

Source: Moss OA, Friedman GG, Yerraguntala AS, Sockolov M, Chen L-X. Evaluation of functional and nutrition status in the older transplant candidate. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2019 (Abstract TH-PO1135), November 7, 2019, Washington, DC.