Background:
Chronic kidney disease (CKD) affects nearly 850 million individuals globally, with end-stage kidney disease (ESKD) increasingly managed through kidney transplantation. While transplantation offers superior outcomes compared to dialysis, kidney transplant candidates (KTC) often experience frailty and functional decline, which are associated with adverse post-transplant outcomes. Multimodal prehabilitation—integrating physical, nutritional, and psychological interventions—has emerged as a promising approach to improve patient resilience. However, clinical trials in this population lack consistency in outcome reporting, limiting comparability and evidence translation.
Objective:
The Kidney Prehabilitation Research for Evidence-based Practice (K-PREP) Study aims to establish a core outcome set (COS) for multimodal prehabilitation in adult kidney transplant candidates, informed by international consensus across patients, caregivers, and multidisciplinary healthcare professionals.
Scope:
The COS will apply to adult KTCs (>18 years), including those on haemodialysis, peritoneal dialysis, or pre-dialysis, excluding candidates for multi-organ transplants. It is intended for use in future research and clinical trials evaluating multimodal prehabilitation programs.
During the literature review and registration process, we explored that SONG-Tx, SONG-HD and SONG-PD COS, which may potentially overlap with our study outcomes e.g, adverse events and Quality of life. These will be explored further in the development of our study. Our study is unique and novel in developing Core outcome set in Renal Transplant waitlist candidates who will benefit from multimodal prehabilitation(Exercise, Nutrition, and Behavioural enhancement), an area which is evolving enormously as a new entity with strong recommendations from major transplant societies in this population.
While initiatives such as the DISCO trial have established core outcome sets for multimodal prehabilitation in colorectal surgery, no consensus-derived COS framework currently exists for kidney transplant candidates, a group with distinct clinical challenges and priorities. To address this gap, there is a pressing need to standardize outcome measures, their definitions, and assessment tools. Hence our Delphi study(K-PREP, Kidney Prehabilitation Research for Evidence-based Practice) responds to this call by seeking international consensus from multidisciplinary stakeholders on a core outcome set specifically for Multimodal prehabilitation trial in KTC.
Dissemination:
Results will be shared through peer-reviewed publications, conference presentations, and engagement with professional bodies and patient advocacy groups. The final COS will support consistent, high-quality research and facilitate the integration of prehabilitation into routine kidney transplant care.
Keywords:
Core outcome set, kidney transplant, prehabilitation, Delphi study, frailty, CKD, multimodal intervention, patient-reported outcomes, COMET, COS-STAD
Ms Sadia Tasleem - Principal Investigator
Mr Dilan Dabare - Supervisor
Disease Category: Kidney disease
Disease Name: Chronic kidney disease , End-stage kidney disease
Age Range: 18 - 120
Sex: Either
Nature of Intervention: Other
- Charities
- Clinical experts
- Consumers (caregivers)
- Patient/ support group representatives
- Researchers
- Service providers
- COS for clinical trials or clinical research
- Consensus conference
- Delphi process
- Focus group(s)
- Literature review
- Systematic review
Stage 1: Development of Longlist/ COS Domains by conducting Systematic Review and PPI meeting
Steering committee to create COS Domains
Stage 2: Shortlisting of COS by conduction international 3 Round Delphi Survey via REDCap
Stage 3: Finalisation Of COS
Core outcomes Set Consensus Meeting to finalise COS
Dissemination of results