Wajiha Ghazi’s bio

Wajiha Ghazi is a Master’s student working in clinical research at Toronto General Hospital. She is passionate about assessing physical function and physical activity of patients in clinical settings. Her current research work focuses on the assessment of physical function among kidney transplant recipients using patient-reported outcomes. She is enthusiastic about integrating physical function assessments in routine clinical care using patient reported outcomes.

Physical function impairment among patients on dialysis and kidney transplant recipients

Ram Ahuja, Corrin Doucette, Zain Ahmad, Nathaniel Edwards, John Peipert, Susan J Bartlett, Madeline Li, Doris Howell, Marta Novak, Istvan Mucsi

Patients treated with dialysis are reported to live a sedentary life and have impaired physical function which is associated with a poor quality of life. Compared to dialysis, kidney transplant provides better clinical outcomes; however, many kidney transplant recipients are also sedentary and have low physical function. In this study, we aim to assess physical function impairment among patients on dialysis and kidney transplant recipients.

We assessed physical function impairment using the Patient Reported Outcomes Measurement Information System (PROMIS), which is a tool that includes item banks for different domains of health-related quality of life including physical function. PROMIS is efficient and precise as it personalizes the assessment and reduces question burden. Participants also completed the EuroQol EQ-5D-5L questionnaire which covers five domains (mobility, self-care, usual activities, pain or discomfort and depression). We found that kidney transplant recipients had a higher PROMIS physical function scores than patients on dialysis. Moderate-to-severe physical function impairment was prevalent in 70% of patients on dialysis compared to 25% in kidney transplant recipients. Similarly, 66% patients on dialysis reported at least some “problems walking” on the EQ-5D-5L mobility item compared to 38% of kidney transplant recipients

These results can help improve the interpretation of PROMIS physical function scores and help patients and clinicians to determine the need for exercise intervention. In future research, we will compare performance-based measures with PROMIS and investigate if exercise interventions can reverse physical function impairment in this patient population.