title: Frailty and delayed graft function in kidney transplant recipients.
abstract: 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.
authors.affiliation: Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Garonzik-Wang
authors.forename: Priyanka
authors.initials: P
authors.lastname: Govindan
authors.forename: Jack W
authors.initials: JW
authors.lastname: Grinnan
authors.forename: Minghao
authors.initials: M
authors.lastname: Liu
authors.forename: Hassan M
authors.initials: HM
authors.lastname: Ali
authors.forename: Anindita
authors.initials: A
authors.lastname: Chakraborty
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Jain
authors.forename: Reside L
authors.initials: RL
authors.lastname: Ros
authors.forename: Nathan T
authors.initials: NT
authors.lastname: James
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Kucirka
authors.forename: Erin C
authors.initials: EC
authors.lastname: Hall
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Berger
authors.forename: Robert A
authors.initials: RA
authors.lastname: Montgomery
authors.forename: Niraj M
authors.initials: NM
authors.lastname: Desai
authors.forename: Nabil N
authors.initials: NN
authors.lastname: Dagher
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Sonnenday
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Englesbe
authors.forename: Martin A
authors.initials: MA
authors.lastname: Makary
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Walston
authors.forename: Dorry L
authors.initials: DL
authors.lastname: Segev
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D051799:Delayed Graft Function / Q000503:physiopathology*; D005260:Female; D018737:Hand Strength; D006304:Health Status; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000473:pathology* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult