Frailty Prevalence and Characterization Among Kidney Transplant Candidates in Spain: A Multicenter Study

Area of Science:

• Nephrology
• Geriatrics
• Public Health

Background:

• Frailty is a significant predictor of adverse outcomes in kidney transplant candidates (KTc).
• Understanding frailty prevalence is crucial for optimizing pre-transplant care and post-transplant results.

Purpose of the Study:

• To determine the prevalence of frailty and pre-frailty in a representative Spanish KTc population.
• To identify demographic and clinical factors associated with frailty in this cohort.

Main Methods:

• A multicenter, cross-sectional study involving 1194 KTc aged 50 years and older.
• Frailty assessment using the validated FRAIL scale.
• Statistical analysis including multivariable logistic regression to identify associated factors.

Main Results:

• 8.2% of KTc were classified as frail, and 41.5% as pre-frail, totaling nearly 50% affected.
• Frailty was significantly more prevalent in females (OR 3.9), patients with higher comorbidity burden (CCI >6, OR 2.9), and those on more medications (OR 1.13 per medication).
• Higher prevalence observed in women, hemodialysis patients, and those with a high Charlson Comorbidity Index (CCI).

Conclusions:

• Almost half of Spanish KTc are pre-frail or frail, highlighting a substantial at-risk population.
• Frailty is independently associated with female sex, high comorbidity burden, and polypharmacy.
• Early identification of frailty in KTc is essential for risk stratification and developing targeted interventions to improve transplant outcomes.