Nephrology Department, Hospital Regional Universitario de Málaga and University of Málaga, IBIMA (Malaga Institute of Biomedical Research)-Plataforma BIONAND, RICORS2040 (RD21/0005/0012), Málaga, Spain.
Nephrology Department, Hospital Regional Universitario de Málaga and University of Málaga, IBIMA (Malaga Institute of Biomedical Research)-Plataforma BIONAND, RICORS2040 (RD21/0005/0012), Málaga, Spain.
Transplant Proc. 2023 Dec;55(10):2271-2274. doi: 10.1016/j.transproceed.2023.08.028. Epub 2023 Sep 30.
Frailty is a persistent chronic inflammatory syndrome present in many patients with chronic kidney disease. After kidney transplant (KT), it has been associated with complications such as delayed graft function, hospital readmission, or poorer KT survival.
To assess the impact of frailty on the results of KT.
Longitudinal prospective study of 65 patients included on the waiting list (WL) between October 2019 and October 2021. We used the FRAIL scale and recorded clinical characteristics, including demographic, dependency scales, and analytical parameters at the moment of the inclusion on the WL and at months 3 and 12 after KT.
The mean age was 58 years old, and 70% of KT were men. The comorbidity burden was 26% diabetes, 83% hypertension, and 12% ischemic heart disease. Forty patients (61.5%) presented ≥1 point on the FRAIL scale, and 25 (38.4%) were robust. Frail patients (FRAIL score≥3) had a higher Charlson comorbidity index at the time of KT, a lower Barthel index, and a lower quality of life measured by KDQOL-36. No significant differences were observed in other variables, such as days of admission, surgical complications, or delayed graft function. There were 3 graft losses censored for death and 4 deaths, all in frail or prefrail patients. These patients had lower graft survival (P = .164) and patient survival (P = .096). At 12 months post KT, frailty improved in 67% of patients evaluated.
Frailty is a common condition among patients on the WL, leading to poorer quality of life, greater dependency, and a higher risk of graft loss and mortality. Frailty conditions can be reversed in many patients after KT.
衰弱是许多慢性肾脏病患者中存在的一种持续的慢性炎症综合征。肾移植（KT）后，它与延迟移植物功能、医院再入院或更差的 KT 生存等并发症有关。
评估衰弱对 KT 结果的影响。
对 2019 年 10 月至 2021 年 10 月期间纳入等待名单（WL）的 65 名患者进行了一项前瞻性纵向研究。我们使用 FRAIL 量表，并记录了临床特征，包括人口统计学、依赖量表和 WL 纳入时及 KT 后 3 个月和 12 个月的分析参数。
患者的平均年龄为 58 岁，70%的 KT 为男性。合并症负担为 26%糖尿病、83%高血压和 12%缺血性心脏病。40 名（61.5%）患者的 FRAIL 量表得分≥1 分，25 名（38.4%）患者身体健壮。衰弱患者（FRAIL 评分≥3）在 KT 时的 Charlson 合并症指数更高，Barthel 指数更低，KDQOL-36 测量的生活质量更差。其他变量，如住院天数、手术并发症或延迟移植物功能，无显著差异。有 3 例移植物丢失因死亡而被删失，4 例死亡，均发生在衰弱或衰弱前期患者中。这些患者的移植物存活率（P=0.164）和患者存活率（P=0.096）较低。在 KT 后 12 个月时，67%评估的患者的衰弱状况得到改善。
衰弱是 WL 患者的常见病症，导致生活质量更差、依赖性更大、移植物丢失和死亡率更高。在许多患者中，KT 后衰弱状况可以逆转。
