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Frailty and Long-Term Post-Kidney Transplant Outcomes

  • Mara A. McAdams-DeMarcoEmail author
  • Nadia M. Chu
  • Dorry L. Segev
Frailty and Gerontology (M McAdams-Demarco, Section Editor)
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Part of the following topical collections:
  1. Topical Collection on Frailty and Gerontology

Abstract

Purpose of Review

To highlight recent research about frailty and its role as a predictor of adverse, long-term post-kidney transplant (KT) outcomes.

Recent Findings

Frailty is easily measured using the physical frailty phenotype (PFP) developed by gerontologist Dr. Linda Fried and colleagues. In recent studies, > 50% of KT recipients were frail (20%) or intermediately frail (32%) at KT admission. Frail recipients were at 1.3-times higher risk of immunosuppression intolerance and 2.2-times higher risk of mortality, even after accounting for recipient, donor, and transplant factors; these findings were consistent with those on short-term post-KT outcomes. Pilot data suggests that prehabilitation may be an intervention that increases physiologic reserve in frail KT recipients.

Summary

PFP is an effective tool to measure frailty in ESRD that improves risk stratification for short-term and long-term post-KT outcomes. Interventions to improve physiologic reserve and prevent adverse KT outcomes, particularly among frail KT recipients, are needed.

Keywords

Frailty Kidney transplantation Epidemiology 

Notes

Funding

This study was supported by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) grant numbers: R01DK114074 (PI: McAdams-DeMarco), K24DK101828 (PI: Segev), and the National Institute on Aging (NIA) grant numbers: R01AG042504 (PI: Segev), K01AG043501 (PI: McAdams-DeMarco), and R01AG055781 (PI: McAdams-DeMarco). Mara A. McAdams-DeMarco was also supported by the Johns Hopkins University Claude D. Pepper Older Americans Independence Center (P30AG021334).

Compliance with Ethical Standards

Conflict of Interest

Mara McAdams-DeMarco, Nadia Chu, and Dorry Segev declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mara A. McAdams-DeMarco
    • 1
    • 2
    Email author
  • Nadia M. Chu
    • 1
    • 2
  • Dorry L. Segev
    • 1
    • 2
  1. 1.Department of SurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA

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