Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brazil.
Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
J Bras Nefrol. 2024 Oct-Dec;46(4):e20240048. doi: 10.1590/2175-8239-JBN-2024-0048en.
Frailty, defined as an inappropriate response to stressful situations due to the loss of physiological reserve, was initially described in the elderly population, but is currently being identified in younger populations with chronic diseases, such as chronic kidney disease. It is estimated that about 20% of patients are frail at the time of kidney transplantation (KT), and there is great interest in its potential predictive value for unfavorable outcomes. A significant body of evidence has been generated; however, several areas still remain to be further explored. The pathogenesis is poorly understood and limited to the extrapolation of findings from other populations. Most studies are observational, involving patients on the waiting list or post-KT, and there is a scarcity of data on long-term evolution and possible interventions. We reviewed studies, including those with Brazilian populations, assessing frailty in the pre- and post-KT phases, exploring pathophysiology, associated factors, diagnostic challenges, and associated outcomes, in an attempt to provide a basis for future interventions.
虚弱是指由于生理储备的丧失，对压力情况产生不适当的反应，最初在老年人群中描述，但目前在患有慢性疾病（如慢性肾脏病）的年轻人群中也被发现。据估计，大约 20%的患者在进行肾移植 (KT) 时身体虚弱，因此人们对其对不良结局的潜在预测价值非常感兴趣。目前已经产生了大量证据；然而，仍有几个领域有待进一步探索。发病机制尚不清楚，仅限于从其他人群中推断发现。大多数研究是观察性的，涉及到等待移植名单上的患者或移植后的患者，而且关于长期演变和可能的干预措施的数据很少。我们对评估了 KT 前后阶段的虚弱情况的研究进行了综述，包括巴西人群的研究，探讨了虚弱的病理生理学、相关因素、诊断挑战和相关结局，以期为未来的干预措施提供依据。
