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Changes in Frailty After Kidney Transplantation.

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Frailty in kidney transplant (KT) recipients initially worsens one month post-surgery but improves by three months. Pre-transplant frailty is a key predictor of long-term outcomes, suggesting it

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Area of Science:

  • Nephrology
  • Gerontology
  • Transplantation Surgery

Background:

  • Frailty is a significant concern in kidney transplant (KT) recipients, impacting post-surgical outcomes.
  • Understanding the natural history of frailty after KT is crucial for patient management and prognostication.

Purpose of the Study:

  • To investigate the longitudinal changes in frailty among adult kidney transplant recipients.
  • To identify factors associated with improvements and long-term changes in frailty post-KT.

Main Methods:

  • Prospective cohort study of 349 kidney transplant recipients.
  • Fried frailty score assessed at KT and during follow-up.
  • Cox proportional hazards and multilevel mixed-effects Poisson models used for analysis.

Main Results:

  • Frailty prevalence increased at 1 month post-KT (33.3%) but returned to near baseline by 3 months (17.2%).
  • Frailty scores worsened at 1 month, normalized by 2 months, and improved by 3 months post-KT.
  • Pre-KT frailty was the strongest predictor of frailty improvement and long-term changes.

Conclusions:

  • Frailty in KT recipients exhibits an initial worsening followed by improvement within three months.
  • Pre-transplant frailty is not an irreversible state and is associated with improved physiological reserve post-KT.
  • Findings support KT in frail individuals, highlighting the potential for recovery of physiological function.