5 days ago
Walking Speed Test Predicts Heart Risk Pre–Kidney Transplant
A simple test of walking speed before kidney transplant could predict the risk for mortality and cardiovascular events, enabling clinicians to quickly activate patients with good cardiovascular fitness and target further screening or prehabilitation to those who need it.
METHODOLOGY:
Researchers retrospectively studied 995 patients (median age, 56 years; 36% women) assessed for kidney transplant at the Royal Free London NHS Foundation Trust from June 2014 to August 2022 to determine whether a simple walking speed test could predict the likelihood of abnormal cardiac stress test results and posttransplant outcomes.
Walking speed was assessed by timing patients as they walked 130 m along a hospital corridor — walking to the end, touching the wall at the end of the corridor, and returning to the start point — as fast as they could; participants were then stratified into four quartiles based on the walking speed from fastest (> 1.83 m/sec) to slowest (< 1.35 m/sec).
Pretransplant cardiovascular testing included stress echocardiography or myocardial perfusion scanning, with cardiovascular events defined as non–ST-elevation myocardial infarction, ST-elevation myocardial infarction, and cerebrovascular events.
The mean follow-up duration was 54.2 months.
TAKEAWAY:
The mean time to complete the walking test was 86.9 seconds; 89 patients were unable to complete the test.
Patients in the fastest walking quartile had significantly lower rates of cardiac events (1.62% vs 10.6%) and mortality (5.3% vs 27.9%) and a higher rate of activation for transplant (90.6% vs 55.3%) than those in the slowest walking quartile ( P < .001 for all).
< .001 for all). Patients in the fastest walking quartile also had a lower rate of abnormal cardiac stress test results and a reduced need for coronary angiography, with none requiring coronary intervention prior to activation.
Walking time was a significant predictor of cardiac events ( P = .048) with a high negative predictive value (86.2%) for stress test outcomes.
IN PRACTICE:
"Our study would suggest that a simple and low cost evaluation of walking speed may predict outcomes in patients being evaluated for kidney transplant and provide a good screening test to avoid significant cardiac work up in fitter patients, thus allowing greater scrutiny, with or without attempts to improve cardiovascular reserve, in patients with poorer exercise capacity," the authors wrote.
SOURCE:
This study was led by Pranav Satish of the Royal Free Hospital, Pond Street, London, England. It was published online on May 29, 2025, in Nephrology Dialysis Transplantation .
LIMITATIONS:
T he study's retrospective design and a single assessment of walking speed at the initial evaluation, rather than repeated measures, may have limited the interpretation of the findings. This study did not account for possible changes in walking speed before or after the assessment, which may have affected the reliability of the results. Although the 130-m timed corridor walk test provided a rapid assessment of the cardiorespiratory reserve, it is not internationally standardised.
DISCLOSURES:
This study received no financial support . The authors declared no conflicts of interest.
