P1860PERIOPERATIVE CHANGES IN PHYSICAL FUNCTION AND ACCELEROMETER-MEASURED PHYSICAL ACTIVITY IN PRE-EMPTIVE OR POST-DIALYSIS KIDNEY TRANSPLANT RECEIPIENTS

Abstract

Abstract Background and Aims Pre-emptive kidney transplant (PEKT) is known to have better graft survival, and thereby well established as the optimal treatment for end-stage renal disease patients. On the other hand, the delayed recovery of physical function and physical activity after KT reportedly occurs in approximately 20% of KT recipients, which leads to poor prognosis. However, it is less clear whether PEKT delays recovery of them after KT. We aimed to investigate any differences in perioperative changes in physical function and physical activity for PEKT versus non-PEKT. Method Consecutive 34 recipients who had received a living-donor KT from January 2016 to January 2019 were enrolled in this prospective cohort study. Patient characteristics including age, sex, body mass index, primary cause of kidney disease, smoking habits, and comorbidities were collected at baseline. Six-minute walk distance (6MWD), gait speed, isometric leg strength, accelerometer-measured physical activity (number of steps and moderate to vigorous activity time) and kidney function (eGFR) were assessed at before and 2 months after KT. We divided the recipients into 2 groups: PEKT (n=11) and non-PEKT (n=23), and compared outcomes between the 2 groups using ANCOVA adjusted for baseline patient characteristics. This study was approved by institute ethical committee. Results KT successfully improved eGFR of all the study participants from 6.1±4.6 to 35.4±15.3. PEKT group showed significant shorter dialysis duration as compared with non-PEKT group (mean duration: 0 months in PEKT vs 64.8±95.5 months in non-PEKT, P <0.001). The 6MWD significantly improved after KT in the PEKT group, but not in the non-PEKT group as compared with that of baseline (adjusted mean change [95% confidence interval]: 44.7 [8.2 to 81.2] vs. 8.80 [-32.8 to 15.2], P=0.025). We found a tendency toward improvement of gait speed (0.11 [-0.11 to 0.32] vs. -0.15 [-0.29 to -0.01], P=0.065), and moderate-to-vigorous activity time per day (7.19 [-2.84 to 17.23] vs. -5.60 [-12.97 to 1.77], P=0.057) in the PEKT group. Conclusion PEKT recipients showed higher perioperative changes in physical function and physical activity compared to non-PEKT. Our findings suggest that PEKT may have benefits on early recovery of physical function and physical activity after KT.