The following is a summary of “Frailty and prognosis of patients with kidney transplantation: a meta-analysis,” published in the October 2023 issue of Nephrology by Zheng et al.
Frailty is common in kidney transplant (KT) candidates and recipients, but its effect on outcomes is unclear. Researchers started a retrospective study to assess the relationship between frailty and KT outcomes systematically.
They searched PubMed, Embase, and Cochrane Library databases to find observational studies comparing mortality risk and other clinical outcomes of KT recipients with and without frailty. Two authors independently collected data and conducted statistical analysis, synthesizing findings using a random-effects model that considered heterogeneity.
The results showed that 22.9% (1,435/6,279) of patients in 13 cohort studies exhibited frailty before kidney transplant (KT). Frail patients at admission had a higher mortality rate compared to those without frailty (risk ratio [RR]: 1.97, 95% CI: 1.57 to 2.47, P<0.001; I2= 19%). Subgroup analysis indicated a consistent association between frailty and elevated mortality risk after KT in studies using Physical Frailty Phenotype or other assessment methods and in studies with follow-up durations < or ≥5 years. Furthermore, frailty was linked to a higher incidence of delayed graft function (RR: 1.78, 95% CI: 1.21 to 2.61, P=0.003; I2 = 0%), postoperative complications (RR: 1.88, 95% CI: 1.15 to 3.08, P=0.01; I2 = 0%), and prolonged hospitalization (RR: 1.55, 95% CI: 1.22 to 1.97, P<0.001; I2 = 0%).
They concluded that frailty was associated with higher mortality, delayed graft function, and complications after kidney transplantation.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-023-03358-0