Outcomes of frail patients while waiting for kidney transplantation: differences between physical frailty phenotype and FRAIL scale

Pérez-Sáez, María José; Redondo Pachón, María Dolores; Arias Cabrales, Carlos Enrique; Faura, Anna; Bach Pascual, Anna; Buxeda, Anna; Burballa Tàrrega, Carla, 1988-; Junyent-Iglesias, Ernestina; Crespo Barrio, Marta; Marco Navarro, Ester; Rodríguez-Mañas, Leocadio; Pascual Santos, Julio

doi:http://dx.doi.org/10.3390/jcm11030672

Outcomes of frail patients while waiting for kidney transplantation: differences between physical frailty phenotype and FRAIL scale

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Pérez-Sáez MJ, Redondo-Pachón D, Arias-Cabrales CE, Faura A, Bach A, Buxeda A, Burballa C, Junyent E, Crespo M, Marco E, Rodríguez-Mañas L, Pascual J. Outcomes of frail patients while waiting for kidney transplantation: differences between physical frailty phenotype and FRAIL scale. J Clin Med. 2022 Jan 28;11(3):672. DOI: 10.3390/jcm11030672

Abstract

Frailty is associated with poorer outcomes among patients waiting for kidney transplantation (KT). Several different tools to measure frailty have been used; however, their predictive value is unknown. This is a prospective longitudinal study of 449 KT candidates evaluated for frailty by the Physical Frailty Phenotype (PFP) and the FRAIL scale. During the study period, 296 patients received a KT, while 153 remained listed. Patients who did not get receive a transplant were more frequently frail according to PFP (16.3 vs. 7.4%, p = 0.013). Robust patients had fewer hospital admissions during the 1st year after listing (20.8% if PFP = 0 vs. 43.4% if ≥1, and 27.1% if FRAIL = 0 vs. 48.9% if ≥1) and fewer cardiovascular events (than FRAIL ≥ 1) or major infectious events (than PFP ≥ 1). According to PFP, scoring 1 point had an impact on patient survival and chance of transplantation in the univariate analysis. The multivariable analysis corroborated the result, as candidates with PFP ≥ 3 had less likelihood of transplantation (HR 0.45 [0.26-0.77]). The FRAIL scale did not associate with any of these outcomes. In KT candidates, pre-frailty and frailty according to both the PFP and the FRAIL scale were associated with poorer results while listed. The PFP detected that frail patients were less likely to receive a KT, while the FRAIL scale did not.