BACKGROUND: Frailty is common among advanced chronic kidney disease (CKD) patients who are kidney transplant (KT) candidates, and predisposes to poor outcomes after transplantation. However, frailty is not routinely measured during pretransplant work-up and it is unknown which metric should be used in this specific population. Our aim was to establish frailty prevalence in KT candidates according to different frailty scales. METHODS: Prospective longitudinal study of 451 KT candidates evaluated for frailty by both Physical Frailty Phenotype (PFP) and FRAIL scale at the time of inclusion on the KT waiting list. Clinical and functional characteristics including sociodemographics, comorbidities, disability and nutritional status were recorded. Agreement between PFP and FRAIL scales as well as dissonant patients were analyzed. RESULTS: Mean age was 60.9 years and 31.7% were female. Comorbidity burden among patients was high, with 36.9% and 16.2% presenting with diabetes and ischemic coronary disease, respectively. Disabilities were also frequent. More than 70% of patients presented with ≥ 1 PFP criteria while this percentage for ≥ 1 FRAIL criteria was 45.4%. Agreement between PFP and FRAIL was not good (kappa index 0.317). There were 132 patients who were pre-frail or frail according to PFP but non-frail according to the FRAIL scale and they presented with fewer comorbidities and less disability. CONCLUSIONS: Frailty is frequent in advanced CKD patients, although its prevalence may vary according to different scales. Agreement between PFP and FRAIL scale is not good, and FRAIL scale might misclassify as robust patients those frail/prefrail patients who are in better health conditions.
BACKGROUND: Frailty is common among advanced chronic kidney disease (CKD) patients who are kidney transplant (KT) candidates, and predisposes to poor outcomes after transplantation. However, frailty is not routinely measured during pretransplant work-up and it is unknown which metric should be used in this specific population. Our aim was to establish frailty prevalence in KT candidates according to different frailty scales. METHODS: Prospective longitudinal study of 451 KT candidates evaluated for frailty by both Physical Frailty Phenotype (PFP) and FRAIL scale at the time of inclusion on the KT waiting list. Clinical and functional characteristics including sociodemographics, comorbidities, disability and nutritional status were recorded. Agreement between PFP and FRAIL scales as well as dissonant patients were analyzed. RESULTS: Mean age was 60.9 years and 31.7% were female. Comorbidity burden among patients was high, with 36.9% and 16.2% presenting with diabetes and ischemic coronary disease, respectively. Disabilities were also frequent. More than 70% of patients presented with ≥ 1 PFP criteria while this percentage for ≥ 1 FRAIL criteria was 45.4%. Agreement between PFP and FRAIL was not good (kappa index 0.317). There were 132 patients who were pre-frail or frail according to PFP but non-frail according to the FRAIL scale and they presented with fewer comorbidities and less disability. CONCLUSIONS: Frailty is frequent in advanced CKD patients, although its prevalence may vary according to different scales. Agreement between PFP and FRAIL scale is not good, and FRAIL scale might misclassify as robust patients those frail/prefrail patients who are in better health conditions.
Authors: Baback Roshanravan; Minesh Khatri; Cassianne Robinson-Cohen; Greg Levin; Kushang V Patel; Ian H de Boer; Stephen Seliger; John Ruzinski; Jonathan Himmelfarb; Bryan Kestenbaum Journal: Am J Kidney Dis Date: 2012-07-07 Impact factor: 8.860
Authors: Lorien S Dalrymple; Ronit Katz; Dena E Rifkin; David Siscovick; Anne B Newman; Linda F Fried; Mark J Sarnak; Michelle C Odden; Michael G Shlipak Journal: Clin J Am Soc Nephrol Date: 2013-10-31 Impact factor: 8.237
Authors: Daniel Murphy; Charles E McCulloch; Feng Lin; Tanushree Banerjee; Jennifer L Bragg-Gresham; Mark S Eberhardt; Hal Morgenstern; Meda E Pavkov; Rajiv Saran; Neil R Powe; Chi-Yuan Hsu Journal: Ann Intern Med Date: 2016-08-02 Impact factor: 25.391
Authors: Michael G Shlipak; Catherine Stehman-Breen; Linda F Fried; Xiao Song; David Siscovick; Linda P Fried; Bruce M Psaty; Anne B Newman Journal: Am J Kidney Dis Date: 2004-05 Impact factor: 8.860
Authors: Maria Pippias; Vianda S Stel; Anneke Kramer; Jose M Abad Diez; Nuria Aresté-Fosalba; Carole Ayav; Jadranka Buturovic; Fergus J Caskey; Frederic Collart; Cécile Couchoud; Johan De Meester; James G Heaf; Ilkka Helanterä; Marc H Hemmelder; Myrto Kostopoulou; Marlies Noordzij; Julio Pascual; Runolfur Palsson; Anna Varberg Reisaeter; Jamie P Traynor; Ziad Massy; Kitty J Jager Journal: Transpl Int Date: 2018-03-02 Impact factor: 3.782