Prehabilitation for Adults With End Stage Renal Disease on the Kidney Transplant Waitlist

Study Overview
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Brief Summary
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This pilot study will be a clinical trial to test the feasibility and effectiveness of a kidney transplant (KT) prehabilitation intervention in adults with end stage renal disease (ESRD) who are within 3-6 months of transplantation.

Detailed Description
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Prehabilitation is the enhancement of functional capacity of a patient to improve their ability to withstand a future stressor. The investigators primary objective is to demonstrate feasibility for prehabilitation in Aim 1 and test whether the number of prehabilitation sessions is associated with increased physical activity. The investigators will formally test whether prehabilitation is associated with a reduction in short term and long term KT outcomes as part of Aim 2. The investigators will test whether there is an effect of prehabilitation on short-term (KT length of stay> 2 weeks, early hospital readmission and delayed graft function) and long-term (acute rejection (within the first year), 1 year patient and graft survival) outcomes compared to standard of care controls. Participants will be followed for 3-6 months or until they receive a kidney transplant.

Official Title
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Prehabilitation for Adults With End Stage Renal Disease on the Kidney Transplant Waitlist

Conditions
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Kidney Failure, Chronic

Intervention / Treatment
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* Other: Prehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women with end stage renal disease who are within 3-6 months of kidney transplantation and are on the kidney transplant waitlist at Johns Hopkins Must be at least 18 years or older at enrollment Must be English speaking Must be enrolled in an ongoing cohort study of adults with ESRD who are being evaluated for kidney transplantation Must be willing to participate in a prehabilitation program and able to give informed consent Exclusion Criteria: Patients who have any of the following medical conditions will be excluded from the study: Active Angina pectoris Chronic lung disease and daily use of oxygen Cerebral vascular disease Musculoskeletal conditions that would limit participation in prehabilitation Lower- or upper-extremity amputation Orthopedic disorders exacerbated by physical activity Decreased mental capacity Patients who live outside of Maryland will not be included in the study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Prehabilitation<br> | Other: Prehabilitation<br>* The study will use a generic prehabilitation program which will include the following components: Warm-up, cardiovascular training, strength training, flexibility training, and cool down. Prehabilitation will occur once per week and approximately 1 hour in duration. Participants will take part in prehabilitation until they receive a kidney transplant which by study design is approximately for 3-6 months.<br>* Other names: exercise training;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post kidney transplant mortality | 1 year patient survival | 1 year |