Frailty and Delayed Graft Function in Kidney Transplant Recipients

• Published in: Archives of surgery (Chicago. 1960) Vol. 147; no. 2; pp. 190 - 193
• Main Authors: Garonzik-Wang, Jacqueline M, Govindan, Priyanka, Grinnan, Jack W, Liu, Minghao, Ali, Hassan M, Chakraborty, Anindita, Jain, Vaibhav, Ros, Reside L, James, Nathan T, Kucirka, Lauren M, Hall, Erin C, Berger, Jonathan C, Montgomery, Robert A, Desai, Niraj M, Dagher, Nabil N, Sonnenday, Christopher J, Englesbe, Michael J, Makary, Martin A, Walston, Jeremy D, Segev, Dorry L
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Medical Association 01.02.2012
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Delayed Graft Function - physiopathology; Female; Frailty; General aspects; Hand Strength; Health Status; Humans; Kidney diseases; Kidney Failure, Chronic - surgery; Kidney Transplantation - pathology; Kidney Transplantation - physiology; Male; Medical sciences; Middle Aged; Multivariate Analysis; Nephrology; Prospective Studies; Risk Assessment; Surgery; Transplants & implants; Treatment Outcome; Young Adult; Medicine; Treatment; Urinary system; Surgery; Frailty in elderly; Graft; Transplantation; Homotransplantation; Kidney; Delayed graft function
• ISSN: 0004-0010; 2168-6254; 1538-3644; 2168-6262
• DOI: 10.1001/archsurg.2011.1229

The ability to predict outcomes following a kidney transplant is limited by the complex physiologic decline of kidney failure, a latent factor that is difficult to capture using conventional comorbidity assessment. The frailty phenotype is a recently described inflammatory state of increased vulnerability to stressors resulting from decreased physiologic reserve and dysregulation of multiple physiologic systems. We hypothesized that frailty would be associated with delayed graft function, based on putative associations between inflammatory cytokines and graft dysfunction. We prospectively measured frailty in 183 kidney transplant recipients between December 2008 and April 2010. Independent associations between frailty and delayed graft function were analyzed using modified Poisson regression. Preoperative frailty was independently associated with a 1.94-fold increased risk for delayed graft function (95% CI, 1.13-3.36; P = .02). The assessment of frailty may provide further insights into the pathophysiology of allograft dysfunction and may improve our ability to preoperatively risk-stratify kidney transplant recipients.