Factors associated with frailty in kidney transplant recipients: A cross‐sectional study

Abstract

Background Frailty is prevalent in kidney transplant recipients and associated with multiple health care challenges. The association between frailty and outcomes has been extensively studied in kidney transplant recipients, but the status of frailty and its associated factors are not well studied, hindering efforts to develop strategies to improve care and reduce frailty. Objectives To identify the factors that are associated with frailty in kidney transplant recipients comprehensively. Design and Participants The associated factors of frailty were explored by a cross‐sectional study of 185 kidney transplant recipients. Measurements Data were collected using the general information questionnaire, the Charlson comorbidity index, the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Connor‐Davidson Resilience Scale, the Perceived Social Support Scale and the Tilburg Frailty Indicator. Data were analyzed using the multiple linear regression analysis. Results A total of 75 (40.5%) kidney transplant recipients were assessed as frail by Chinese TFI. Age (β = 0.228), time post‐transplant (β = 0.055), sleep quality (β = 0.224) and psychological resilience (β = −0.038) entered the final multiple regression equation and accounted for 41.8% of the total frailty variation (R2 = 0.418, F = 21.31, p < 0.05). Conclusions Frailty was common among kidney transplant recipients. Old age, long time after transplantation, poor sleep quality and low psychological resilience were main associated factors for frailty. Integrated care interventions are therefore needed for this vulnerable population to prevent or delay frailty.

Prevalence of frailty and cognitive impairment in older transplant candidates - a preview to the Kidney Transplantation in Older People (KTOP): impact of frailty on outcomes study

“…Additionally, comorbidity burden, diabetes, and peripheral vascular disease were found to be significantly different across the categories of frailty status, but not cognitive impairment. These characteristics are in keeping with risk factors for frailty and cognitive impairment development reported in existing literature [11,12,14,16]. Subsequent analyses and publications from the KTOP study will determine the association of these factors, and others, on the longitudinal changes in frailty and cognitive function which occur over time, and their impact on clinical and experiential outcomes in this cohort.…”

“…Within the group identified as frail (29), 18 participants were defined as having 'mild frailty' (EFS score 8-9), 10 participants had 'moderate frailty' (EFS score 10-11) and 1 participant was identified as having 'severe frailty' (EFS score [12][13][14][15][16][17]. Figure 3 illustrates the distribution of EFS scores across the cohort and how these scores translate into a frailty status.…”

“…At all ages, chronic kidney disease and ESKD populations are more susceptible to developing frailty and cognitive impairment when compared to the general population [11][12][13]. Frailty is a multidimensional syndrome which results from progressive and sustained degeneration in several physiological systems [11,14]. It characterises the differences in physiological and chronological age and produces a spectrum of deficits with confer an increased susceptibility to physical stressors and an increased risk of adverse outcomes [11,12,14].…”

“…Frailty is a multidimensional syndrome which results from progressive and sustained degeneration in several physiological systems [11,14]. It characterises the differences in physiological and chronological age and produces a spectrum of deficits with confer an increased susceptibility to physical stressors and an increased risk of adverse outcomes [11,12,14]. Frailty has been reported to affect anywhere between 14 and 73% of adult dialysis dependent patients, and cognitive impairment present in up to 80% [12,15].…”

Targeted Non-Pharmacological Interventions for People Living with Frailty and Chronic Kidney Disease

“…There is a particular need to understand how people with CKD think and respond to symptoms of frailty and how these factors are associated with subsequent self-management behaviours, symptom severity, and impairment. In kidney transplant recipients, psychological resilience has been found to be associated with frailty [124], and in community-dwelling older adults, self-efficacy and a sense of mastery have been found to reduce the odds of functional decline [125]. Such factors are also commonly associated with depression.…”