Transitions in frailty state after kidney transplantation
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ORIGINAL ARTICLE
Transitions in frailty state after kidney transplantation Evelien E. Quint 1 & Lasse Schopmeyer 1 & Louise B.D. Banning 1 & Cyril Moers 1 & Mostafa El Moumni 1 Gertrude J. Nieuwenhuijs-Moeke 2 & Stefan P. Berger 3 & Stephan J.L. Bakker 3 & Robert A. Pol 1
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Received: 2 April 2020 / Accepted: 10 July 2020 # The Author(s) 2020
Abstract Purpose Frailty is the body’s failure to return to homeostasis after every day or acute stressful events, causing adverse outcomes. To study its dynamics in kidney transplant recipients (KTR), we determined whether the degree of frailty and its domains are affected by kidney transplantation (KT). Methods Between 2015 and 2017, 176 KTR were included. Frailty scores were measured using the Groningen Frailty Indicator (GFI), assessed preoperatively and during follow-up. Transitions in frailty state and changes in the individual domains were determined. Results Mean age (±SD) was 51.8 (± 14.1) years, and 63.1% of KTR were male. Thirty patients were considered frail (GFI ≥ 4) at baseline. After a mean follow-up of 22.8 ± 8.3 months, 34 non-frail patients (19.3%) became frail, 125 patients (71.0%) remained the same, and 17 frail patients (9.7%) became non-frail (GFI < 4). In the domain psychosocial functioning, 28.4% of the patients had an increase in GFI score after follow-up. Patients who scored a point in the domain cognition at baseline had a greater chance of becoming frail (OR 4.38, 95% CI 0.59–32.24). Conclusion In conclusion, almost one-fifth of non-frail KTR transitioned to a frail state after their transplantation. These results could be used to predict the impact of KT on frailty course and help with implementing prehabilitation for patients at risk. Keywords Frailty . Kidney transplantation . Cognition . Mental health
Introduction Frailty is a frequently occurring physiological condition in today’s aging population. It is the result of aging-associated decline in physical, cognitive, physiological, and immune reserves which leads to a diminished ability to cope with every day or acute stressors [1–3]. Fried et al. [4] have defined frailty as meeting at least three out of five of the following criteria: unintentional loss of weight, low physical activity, exhaustion, Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00423-020-01936-6) contains supplementary material, which is available to authorized users. * Robert A. Pol [email protected] 1
Department of Surgery, Division of Vascular and Transplantation Surgery, University Medical Centre Groningen, P.O. Box 30 001, 9700 RB Groningen, The Netherlands
2
Department of Anaesthesiology, University Medical Centre Groningen, Groningen, The Netherlands
3
Department of Internal Medicine, Division of Nephrology, University Medical Centre Groningen, Groningen, the Netherlands
low grip strength, and reduced walking speed. An increased inflammatory state, including elevated levels of interleukin 6 and C-reactive protein, has also been reported in frail patients [5]
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