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Updated: Jan 30, 2026

Robot-Assisted Kidney Transplantation

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Published on: July 19, 2021

Frailty and Changes in Cognitive Function after Kidney Transplantation.

Nadia M Chu^1,2, Alden L Gross^3,4, Ashton A Shaffer^3,2

¹Departments of Epidemiology, nchu8@jhu.edu mara@jhu.edu.

Journal of the American Society of Nephrology : JASN

|January 26, 2019

Summary

Kidney transplant recipients generally see cognitive gains, but frail individuals experience a decline after the first year. Further research is needed to find interventions for frail kidney transplant patients.

Keywords:

cognition frailty kidney transplantation

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Area of Science:

Nephrology
Gerontology
Neuroscience

Background:

Kidney transplant recipients often experience improved cognitive function post-surgery.
The impact of frailty on cognitive trajectories after kidney transplantation remains unclear.
Frail individuals may be more susceptible to surgical stressors, potentially affecting cognitive outcomes.

Purpose of the Study:

To assess the effect of pre-transplant frailty on cognitive function trajectories in kidney transplant recipients.
To investigate short- and medium-term cognitive changes up to 4 years post-transplant.
To compare cognitive outcomes between frail and non-frail kidney transplant recipients.

Main Methods:

A two-center cohort study involving adult kidney transplant recipients.
Assessment of pre-transplant frailty using the Fried physical frailty phenotype.
Measurement of cognitive function using the Modified Mini-Mental State Examination up to 4 years post-transplant.
Analysis using an adjusted mixed-effects model to characterize cognitive trajectories.

Main Results:

15.0% of 665 recipients were identified as frail.
Frail recipients had lower pre-transplant cognitive scores.
Both frail and non-frail recipients showed short-term cognitive improvement within 3 months.
Non-frail recipients' cognitive function plateaued between 1-4 years, while frail recipients experienced cognitive decline.
At 4 years, frail recipients had significantly lower cognitive scores than non-frail recipients.

Conclusions:

Kidney transplant recipients generally experience initial cognitive improvement.
Pre-transplant frailty is linked to medium-term cognitive decline post-kidney transplant.
Identifying interventions to prevent cognitive decline in frail kidney transplant recipients is crucial.