TY - JOUR
T1 - Prevalence of frailty among kidney transplant candidates and recipients in the United States
T2 - Estimates from a National Registry and Multicenter Cohort Study
AU - Haugen, Christine E.
AU - Thomas, Alvin G.
AU - Chu, Nadia M.
AU - Shaffer, Ashton A.
AU - Norman, Silas P.
AU - Bingaman, Adam W.
AU - Segev, Dorry L.
AU - McAdams-DeMarco, Mara
N1 - Funding Information:
Funding for this study was provided in part by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) and the National Institute on Aging (NIA) grant numbers F32AG053025 (PI: Christine Haugen), F30DK116658 (PI: Ashton Shaffer), K24DK101828 (PI: Dorry Segev), and R01AG055781 (PI: Mara McAdams‐DeMarco). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government. The data reported here have been supplied by the Hennnepin Healthcare Research Institute (HHRI) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the SRTR, OPTN/UNOS, or the US Government.
Funding Information:
Funding for this study was provided in part by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) and the National Institute on Aging (NIA) grant numbers F32AG053025 (PI: Christine Haugen), F30DK116658 (PI: Ashton Shaffer), K24DK101828 (PI: Dorry Segev), and R01AG055781 (PI: Mara McAdams-DeMarco). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government. The data reported here have been supplied by the Hennnepin Healthcare Research Institute (HHRI) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the SRTR, OPTN/UNOS, or the US Government.
Publisher Copyright:
© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Frailty, a measure of physiologic reserve, is associated with poor outcomes and mortality among kidney transplant (KT) candidates and recipients. There are no national estimates of frailty in this population, which may help patient counseling and resource allocation at transplant centers. We studied 4616 KT candidates and 1763 recipients in our multicenter prospective cohort of frailty from 2008-2018 with Fried frailty measurements. Using Scientific Registry of Transplant Recipients (SRTR) data (KT candidates = 560 143 and recipients = 243 508), we projected the national prevalence of frailty (for KT candidates and recipients separately) using standardization through inverse probability weighting, accounting for candidate/recipient, donor, and transplant factors. In our multicenter cohort, 13.3% of KT candidates were frail at evaluation; 8.2% of LDKT recipients and 17.8% of DDKT recipients were frail at transplantation. Projected nationally, our modeling strategy estimated 91 738 KT candidates or 16.4% (95% confidence interval [CI] 14.4%-18.4%) of all KT candidates during the study period were frail, and that 34 822 KT recipients or 14.3% (95% CI 12.3%-16.3%) of all KT recipients were frail (LDKT = 8.2%; DDKT = 17.8%). Given the estimated national prevalence of frailty, transplant programs should consider assessing the condition during KT evaluation to improve patient counseling and resource allocation along with identification of recipients at risk for poor outcomes.
AB - Frailty, a measure of physiologic reserve, is associated with poor outcomes and mortality among kidney transplant (KT) candidates and recipients. There are no national estimates of frailty in this population, which may help patient counseling and resource allocation at transplant centers. We studied 4616 KT candidates and 1763 recipients in our multicenter prospective cohort of frailty from 2008-2018 with Fried frailty measurements. Using Scientific Registry of Transplant Recipients (SRTR) data (KT candidates = 560 143 and recipients = 243 508), we projected the national prevalence of frailty (for KT candidates and recipients separately) using standardization through inverse probability weighting, accounting for candidate/recipient, donor, and transplant factors. In our multicenter cohort, 13.3% of KT candidates were frail at evaluation; 8.2% of LDKT recipients and 17.8% of DDKT recipients were frail at transplantation. Projected nationally, our modeling strategy estimated 91 738 KT candidates or 16.4% (95% confidence interval [CI] 14.4%-18.4%) of all KT candidates during the study period were frail, and that 34 822 KT recipients or 14.3% (95% CI 12.3%-16.3%) of all KT recipients were frail (LDKT = 8.2%; DDKT = 17.8%). Given the estimated national prevalence of frailty, transplant programs should consider assessing the condition during KT evaluation to improve patient counseling and resource allocation along with identification of recipients at risk for poor outcomes.
KW - Scientific Registry for Transplant Recipients (SRTR)
KW - clinical research/practice
KW - kidney transplantation/nephrology
KW - registry/registry analysis
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U2 - 10.1111/ajt.15709
DO - 10.1111/ajt.15709
M3 - Article
C2 - 31733176
AN - SCOPUS:85076358116
SN - 1600-6135
VL - 20
SP - 1170
EP - 1180
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 4
ER -