H. Shah1, N. Shah2
1Institute of Kidney Diseases and Research Center-Institute of Transplantation Sciences, IKDRC-ITS College of Physiotherapy, Ahmedabad, India, 2SBB College of Physiotherapy, Ahmedabad, India

Background: Kidney transplantation is the best available treatment option for patient with irreversible kidney failure. Achieving optimal functionality is the upmost goal in almost all type of transplants. Although the renal graft survival rate have improved significantly, well-functioning grafts also face the persistent high cardiovascular morbidity. Receipt of a new kidney after transplant is accompanied with many new stressors and adaptive demands like fear of organ rejection and side effects of immune-suppressants. Pre-existing co morbidity, sub optimal graft function and lack of awareness of physical activity participation can lead to sedentary behaviour. Many factors affects the physical function and strength. Number of kidney transplantation are steadily rising in India but at the same time the data on functional capacity and strength after transplant are limited in Indian population.

Purpose: The primary objective of present study was to evaluate functional capacity, functional strength and various factors that affect the physical function among Indian kidney transplantation recipients.

Methods: In this single center prospective observational study; Kidney transplant recipients with age between 18 to 60 years, having eGFR ≥ 45ml/min/1.72m2 and post kidney transplant duration more than  6 months were included with convenient sampling method. Age, BMI, abdominal circumference (AC), comorbidity, post-transplant duration (PTD), dialysis vintage (DV), eGFR were noted. Total physical activity (TPA) and sedentary time (ST) was evaluated through IPAQ-LF. Functional capacity and strength were evaluated using series of objective measures like distance walked in six minute walk test (6MWD), dominant hand grip strength test (DHGS), one minute sit to stand chair test (1MSTS) and five times sit to stand chair test (5XSTS). To explore function capacity and strength; we carried out a multiple linear regression, with each explanatory variables.

Results: Total 149 subjects were analyzed. When compared with gender matched normal reference value for BMI and abdominal circumference for Indian population; 48 were overweight, 8 were Obese, 98 had high abdominal circumference. 41% participants had no co-morbidity, 48% had minimum one co morbidity, 34% were low physically active. 6MWD was 392 ±96.2 meters, DHGS was 33.1± 6.8 kg, 1MSTS was 24.0 ±3.7 repetition and 5XSTS was 10.6 ±1.9 seconds. 6MWD decreased on average by 1.92 meter; when AC increased by 1 unit (p = 0.034). 6MWD of the group having  TPA >320MET min/Week was on average superior of 30.4meter (p = 0.023). DHGS increased on average by 0.110 Kg, when eGFR increased by 1 unit, (p = 0.035) and  it increased 0.750 Kg when TPA increased by 100 units (p = 0.017). Number of sit to stand repetition in one minute reduced by 1.18 in group who had BMI >25kg/m2 than the group who had BMI ≤25 kg/m2 (p = 0.041). Time taken to do five times sit to stand reduce by 0.214 seconds; when TPA increases by 100 units, (p = 0.017).

Conclusion(s): Functional capacity and strength depends upon physical activity, anthropometry and kidney function among Indian kidney transplant recipients.

Implications: Transplantation rehabilitation is relatively new and emerging field in India. Encouragement, Education and Implementation towards more active lifestyle is upmost need after kidney transplantation.

Funding, acknowledgements: No funding was received for this research work.

Keywords: Kidney transplantation, Functional capacity, Functional strength

Topic: Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes
Institution: IKDRC-ITS,Medicity, Ahmedabad
Committee: IKDRC-ITS Ethical Committee
Ethics number: Indian Trial Register CTRI- 035366

All authors, affiliations and abstracts have been published as submitted.

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