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

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.

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.