The transition of frailty state after kidney transplantation

E. E. Quint, L. Schopmeyer, L. B. D. Banning, C. Moers, M. El Moumni, G. J. Nieuwenhuijs-Moeke, S. P. Berger, S.J.L. Bakker, R.A. Pol

Wednesday 4 march 2020

15:10 - 15:20h at Theaterzaal

Parallel session: Parallel sessie III – Klinische abstracts

Background: In today’s aging population, an increasing number of patients are becoming frail. Frailty results from the body’s failure to return to homeostasis after stressful events, leading to adverse outcomes. To study the dynamics of frailty in kidney transplant recipients we aimed to determine whether transitions in frailty and its specific domains are affected by the kidney transplantation.

Methods: A total of 176 kidney transplant recipients, transplanted between 2015-2017, were prospectively included. The presence and severity of frailty was measured using the Groningen Frailty Indicator (GFI). Frailty was assessed preoperatively during admittance (index measurement) and during follow-up. Transitions in frailty state and the individual domains, were determined between the index and the follow-up measurement. Additionally, specific changes in the different domains of the GFI and contributing patient characteristics were analyzed.

Results: Mean age (SD) was 51.8 (14.1) years and 63% were male. Sixty percent of the patients were dialysis dependent prior to the transplantation and 83% received a kidney from a living donor. Thirty patients (17%) were considered frail (GFI > 4) at baseline. After a mean follow-up of 22.8 ± 8.3 months, 34 patients (19%) transitioned from a non-frail to a frail state, 125 patients (71%) remained the same and 17 patients (10%) transitioned from a frail to a non-frail state (GFI < 4). The individual frailty domains “limited cognition” (19%) and “limited psychosocial functioning” (28%) contributed most to a deterioration in frailty state.

Conclusions: Almost one fifth of kidney transplant recipients transitioned from a non-frail to a frail state after their transplantation. These results can be used to inform patients on the impact of kidney transplantation and manage expectations regarding physical and cognitive decline after surgery. More emphasis needs to be put on specific, preventative interventions which combat the decline of the individual frailty domains.