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Journal article
An overview of frailty in kidney transplantation: measurement, management and future considerations
Nephrology, dialysis, transplantation, v 35(7), pp 1099-1112
01 Jul 2020
PMID: 32191296
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The construct of frailty was first developed in gerontology to help identify older adults with increased vulnerability when confronted with a health stressor. This article is a review of studies in which frailty has been applied to pre- and post-kidney transplantation (KT) populations. Although KT is the optimal treatment for end-stage kidney disease (ESKD), KT candidates often must overcome numerous health challenges associated with ESKD before receiving KT. After KT, the impacts of surgery and immunosuppression represent additional health stressors that disproportionately impact individuals with frailty. Frailty metrics could improve the ability to identify KT candidates and recipients at risk for adverse health outcomes and those who could potentially benefit from interventions to improve their frail status. The Physical Frailty Phenotype (PFP) is the most commonly used frailty metric in ESKD research, and KT recipients who are frail at KT (~20% of recipients) are twice as likely to die as nonfrail recipients. In addition to the PFP, many other metrics are currently used to assess pre- and post-KT vulnerability in research and clinical practice, underscoring the need for a disease-specific frailty metric that can be used to monitor KT candidates and recipients. Although frailty is an independent risk factor for post-transplant adverse outcomes, it is not factored into the current transplant program risk-adjustment equations. Future studies are needed to explore pre- and post-KT interventions to improve or prevent frailty.
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Details
- Title
- An overview of frailty in kidney transplantation: measurement, management and future considerations
- Creators
- Meera N Harhay - Drexel UniversityMaya K Rao - Columbia UniversityKenneth J Woodside - University of MichiganKirsten L Johansen - Hennepin Healthcare Research InstituteKrista L Lentine - Center for Abdominal Transplantation, St Louis University School of Medicine, St Louis, MO, USAStefan G Tullius - Brigham and Women's HospitalRonald F Parsons - Emory UniversityTarek Alhamad - Washington University in St. LouisJoseph Berger - Southwestern Medical CenterXingXing S Cheng - Stanford UniversityJaqueline Lappin - St David's Medical CenterRaymond Lynch - Emory UniversitySandesh Parajuli - University of Wisconsin School of Medicine and Public HealthJane C Tan - Stanford UniversityDorry L Segev - Johns Hopkins MedicineBruce Kaplan - Scott & White HospitalJon Kobashigawa - Cedars-Sinai Medical CenterDarshana M Dadhania - Synod HospitalMara A McAdams-DeMarco - Johns Hopkins Medicine
- Publication Details
- Nephrology, dialysis, transplantation, v 35(7), pp 1099-1112
- Publisher
- Oxford University Press
- Grant note
- R03 AG053294 / NIA NIH HHS HHSN276201400001C / NLM NIH HHS K23 DK105207 / NIDDK NIH HHS R01 DK120551 / NIDDK NIH HHS R01 AG055781 / NIA NIH HHS R01 DK114074 / NIDDK NIH HHS U01 DK116042 / NIDDK NIH HHS K24 DK085153 / NIDDK NIH HHS K24 DK101828 / NIDDK NIH HHS R01 DK120518 / NIDDK NIH HHS P30 AG021334 / NIA NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000593117800006
- Scopus ID
- 2-s2.0-85089358888
- Other Identifier
- 991019335320504721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Transplantation
- Urology & Nephrology