Frailty is associated with dialysis duration before transplantation in kidney transplant recipients: A Japanese single‐center cross‐sectional study

Abstract

Abbreviations & Acronyms BMI = body mass index CHS = cardiovascular health study CVD = cardiovascular disease eGFR = estimated glomerular filtration rate HbA1c = glycated hemoglobin IQR = interquartile range KCL = Kihon Checklist SD = standard deviation Objectives: To investigate the prevalence of frailty, and the relationship of frailty based on the Kihon Checklist criteria with dialysis duration before transplantation and time after transplantation in kidney transplant recipients. Methods: This study was a single-center, cross-sectional investigation carried out on kidney transplant recipients. To examine the association between the total Kihon Checklist score with time after transplant and dialysis duration before transplant, the multivariable proportional odds logistic regression model was used with adjustment for age, sex, body mass index, estimated glomerular filtration rate and serum albumin levels.Results: Out of 205 kidney transplant recipients enrolled in this study, frail, prefrail and robust recipients accounted for 11.2%, 26.8% and 62.0%, respectively. Dialysis duration before transplantation was associated with frailty, but time after transplant was not associated with frailty. Conclusions: The prevalence of frailty in kidney transplant recipients is approximately 11%, and it is associated with the duration of pretransplant dialysis. These findings suggest that a shorter dialysis duration might be beneficial for preventing frailty in kidney transplant recipients.

Frailty and Kidney Transplantation: A Systematic Review and Meta-analysis

“…All studies were published in English between 2012 and 2020. [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Research for these publications was perfomed between 2008 and 2018. Quality assessment identified 15 studies with a low risk of bias and 3 studies with a moderate risk of bias (Table 1).…”

“…Fourteen prospective cohort studies, [24][25][26][27][28][29][30][31][32][33][34][35][36][37] 3 retrospective cohort studies, [38][39][40] and 1 cross-sectional study 41 were included in this systematic review (Table 2). All studies combined resulted in a cohort of 9545 patients.…”

“…The majority of studies (n = 15) used the Fried frailty phenotype to determine frailty. [24][25][26][28][29][30][31][32][33][34][35][36][37][38][39] The Kihon Checklist (KCL), 41 the Frailty Risk Score, 40 and the Groningen Frailty Indicator 27 were used in 1 study each.…”

Frailty in kidney transplantation: a review on its evaluation, variation and long-term impact

“…However, CKD patients have some peculiarities (Fig. 2 ); for example, frailty is significantly linked to time on dialysis before transplantation [ 48 ]. Polypharmacy, malnutrition and low physical exercise are factors that in the long run can certainly favour, maintain and increase frailty.…”

“…Data published in 2015 showed 5-year survivals of 91.5%, 86.0% and 77.5% for non-frail, mildly frail and frail recipients of RTx, respectively. Furthermore, being frail was independently associated with a >2-fold increased risk of death [ 48 ].…”