Increased mortality after kidney transplantation in mildly frail recipients.
Fried
frailty phenotype
survival
transplant
Journal
Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
31
03
2022
entrez:
3
11
2022
pubmed:
4
11
2022
medline:
4
11
2022
Statut:
epublish
Résumé
Physical Frailty Phenotype (PFP) is the most used frailty instrument among kidney transplant recipients, classifying patients as pre-frail if they have 1-2 criteria and as frail if they have ≥3. However, different definitions of robustness have been used among renal patients, including only those who have 0 criteria, or those with 0-1 criteria. Our aim was to determine the impact of one PFP criterion on transplant outcomes. We undertook a retrospective study of 296 kidney transplant recipients who had been evaluated for frailty by PFP at the time of evaluating for transplantation. Only 30.4% of patients had 0 criteria, and an additional 42.9% showed one PFP criterion. As PFP score increased, a higher percentage of women and cerebrovascular disease were found. Recipients with 0-1 criteria had lower 1-year mortality after transplant than those with ≥2 (1.8% vs 10.1%), but this difference was already present when we only considered those who scored 0 (mortality 1.1%) and 1 (mortality 2.4%) separately. The multivariable analysis confirmed that one PFP criterion was associated to a higher risk of patient death after kidney transplantation [hazard ratio 3.52 (95% confidence interval 1.03-15.9)]. Listed kidney transplant candidates frequently show only one PFP frailty criterion. This has an independent impact on patient survival after transplantation.
Sections du résumé
Background
UNASSIGNED
Physical Frailty Phenotype (PFP) is the most used frailty instrument among kidney transplant recipients, classifying patients as pre-frail if they have 1-2 criteria and as frail if they have ≥3. However, different definitions of robustness have been used among renal patients, including only those who have 0 criteria, or those with 0-1 criteria. Our aim was to determine the impact of one PFP criterion on transplant outcomes.
Methods
UNASSIGNED
We undertook a retrospective study of 296 kidney transplant recipients who had been evaluated for frailty by PFP at the time of evaluating for transplantation.
Results
UNASSIGNED
Only 30.4% of patients had 0 criteria, and an additional 42.9% showed one PFP criterion. As PFP score increased, a higher percentage of women and cerebrovascular disease were found. Recipients with 0-1 criteria had lower 1-year mortality after transplant than those with ≥2 (1.8% vs 10.1%), but this difference was already present when we only considered those who scored 0 (mortality 1.1%) and 1 (mortality 2.4%) separately. The multivariable analysis confirmed that one PFP criterion was associated to a higher risk of patient death after kidney transplantation [hazard ratio 3.52 (95% confidence interval 1.03-15.9)].
Conclusions
UNASSIGNED
Listed kidney transplant candidates frequently show only one PFP frailty criterion. This has an independent impact on patient survival after transplantation.
Identifiants
pubmed: 36325004
doi: 10.1093/ckj/sfac159
pii: sfac159
pmc: PMC9613422
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2089-2096Investigateurs
María José Pérez-Sáez
(MJ)
Carlos E Arias-Cabrales
(CE)
Dolores Redondo
(D)
Francesc Barbosa
(F)
Higini Cao
(H)
Silvia Collado
(S)
Anna Buxeda
(A)
Carla Burballa
(C)
Marta Crespo
(M)
Julio Pascual
(J)
Anna Faura
(A)
María Vera
(M)
Anna Bach
(A)
Guillermo Pedreira
(G)
Ernestina Junyent
(E)
Montserrat Folgueiras
(M)
Yolanda Castillo
(Y)
Aida Martínez
(A)
Marisol Fernández
(M)
Eva Barbero
(E)
Rosa Causadías
(R)
Jesús Carazo
(J)
Lluis Cecchini
(L)
Ester Marco
(E)
Delky Meza de Valderrama
(DM)
Andrea Morgado
(A)
Elena Muñoz
(E)
Xavier Nogués
(X)
Leocadio Rodríguez-Mañas
(L)
Olga Vázquez
(O)
María Dolores Muns
(MD)
Miguel Gárriz
(M)
María Polo Gómez
(MP)
Sara Hurtado
(S)
Maite López
(M)
Laura Ribera
(L)
Margarita Guino
(M)
Ramón Roca
(R)
Jordi Calls
(J)
Alicia Rovira
(A)
Josep Mora
(J)
Omar Ibrik
(O)
Florentina Liria
(F)
Thaïs López
(T)
Jaume Almirall
(J)
Carmen Moya
(C)
Fátima Moreno
(F)
Manel Ramírez de Arellano
(MR)
Sandra Rubio
(S)
Ignacio Cidraque
(I)
Carlota Pájaro
(C)
Núria Garra
(N)
Josep Galcerán
(J)
Marina Fenollar
(M)
Sara Outón
(S)
Fabiola Dapena
(F)
Josep Jara
(J)
Rosa García
(R)
Mònica Manresa
(M)
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.
Références
BMC Nephrol. 2013 Oct 16;14:224
pubmed: 24131569
Nephrol Dial Transplant. 2020 Jul 1;35(7):1099-1112
pubmed: 32191296
J Clin Med. 2022 Jan 28;11(3):
pubmed: 35160125
Transplantation. 2017 Sep;101(9):2126-2132
pubmed: 27779573
J Am Geriatr Soc. 2013 Jun;61(6):896-901
pubmed: 23711111
J Am Coll Cardiol. 2015 Mar 17;65(10):976-83
pubmed: 25766943
J Urol. 2014 May;191(5):1366
pubmed: 24745533
Nefrologia (Engl Ed). 2021 May-Jun;41(3):237-243
pubmed: 33339673
Transplant Direct. 2021 May 18;7(6):e701
pubmed: 34036171
Front Med (Lausanne). 2021 May 19;8:675049
pubmed: 34095178
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
pubmed: 11253156
Am J Nephrol. 2019;49(2):103-110
pubmed: 30625489
Lancet Public Health. 2018 Jul;3(7):e323-e332
pubmed: 29908859
J Am Med Dir Assoc. 2017 Mar 1;18(3):252-258
pubmed: 27838339
Clin Kidney J. 2021 Jul 10;15(1):109-118
pubmed: 35035941
Transplantation. 2018 Feb;102(2):291-299
pubmed: 28885489
Am J Transplant. 2015 Jan;15(1):149-54
pubmed: 25359393
Transplantation. 2015 Apr;99(4):805-10
pubmed: 25393156
Curr Transplant Rep. 2019 Mar;6(1):45-51
pubmed: 31768307
Ann Surg. 2017 Dec;266(6):1084-1090
pubmed: 27655240
J Nephrol. 2022 Sep;35(7):1841-1849
pubmed: 34978704