Increased mortality after kidney transplantation in mildly frail recipients
Author:
Pérez-Sáez María José1ORCID, Arias-Cabrales Carlos E1, Redondo-Pachón Dolores1, Burballa Carla1, Buxeda Anna1, Bach Anna1, Faura Anna1, Junyent Ernestina1, Marco Ester23, Rodríguez-Mañas Leocadio4ORCID, Crespo Marta1, Pascual Julio15, Pérez-Sáez María José, Arias-Cabrales Carlos E, Redondo Dolores, Barbosa Francesc, Cao Higini, Collado Silvia, Buxeda Anna, Burballa Carla, Crespo Marta, Pascual Julio, Faura Anna, Vera María, Bach Anna, Pedreira Guillermo, Junyent Ernestina, Folgueiras Montserrat, Castillo Yolanda, Martínez Aida, Fernández Marisol, Barbero Eva, Causadías Rosa, Carazo Jesús, Cecchini Lluis, Marco Ester, de Valderrama Delky Meza, Morgado Andrea, Muñoz Elena, Nogués Xavier, Rodríguez-Mañas Leocadio, Vázquez Olga, Muns María Dolores, Gárriz Miguel, Gómez María Polo, Hurtado Sara, López Maite, Ribera Laura, Guino Margarita, Roca Ramón, Calls Jordi, Rovira Alicia, Mora Josep, Ibrik Omar, Liria Florentina, López Thaïs, Almirall Jaume, Moya Carmen, Moreno Fátima, de Arellano Manel Ramírez, Rubio Sandra, Cidraque Ignacio, Pájaro Carlota, Garra Núria, Galcerán Josep, Fenollar Marina, Outón Sara, Dapena Fabiola, Jara Josep, García Rosa, Manresa Mònica,
Affiliation:
1. Nephrology Department , Hospital del Mar, Barcelona , Spain 2. Physical Medicine & Rehabilitation Department , Parc de Salut Mar (Hospital del Mar-Hospital de l'Esperança) , , Barcelona , Spain 3. Rehabilitation Research Group, Hospital del Mar Research Institute, Universitat Autònoma de Barcelona , Parc de Salut Mar (Hospital del Mar-Hospital de l'Esperança) , , Barcelona , Spain 4. Geriatrics Department, Hospital Universitario de Getafe , Madrid , Spain 5. Nephrology Department , Hospital Universitario 12 de Octubre, Madrid , Spain
Abstract
ABSTRACT
Background
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
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
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
Listed kidney transplant candidates frequently show only one PFP frailty criterion. This has an independent impact on patient survival after transplantation.
Funder
FIS-FEDER Instituto de Salud Carlos III Spanish Society of Transplant Rio Hortega
Publisher
Oxford University Press (OUP)
Subject
Transplantation,Nephrology
Cited by
5 articles.
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