Frailty among chronic kidney disease patients on the kidney transplant waiting list : the sex-frailty paradox
Pérez-Sáez, María José (Hospital del Mar (Barcelona, Catalunya))
Arias Cabrales, Carlos E (Hospital del Mar (Barcelona, Catalunya))
Dávalos-Yerovi, Vanesa (Institut Hospital del Mar d'Investigacions Mèdiques)
Redondo-Pachón, Dolores (Hospital del Mar (Barcelona, Catalunya))
Faura, Anna (Hospital del Mar (Barcelona, Catalunya))
Vera, María (Hospital del Mar (Barcelona, Catalunya))
Bach Pascual, Anna (Hospital del Mar (Barcelona, Catalunya))
Pedreira, Guillermo (Hospital del Mar (Barcelona, Catalunya))
Junyent, Ernestina (Hospital del Mar (Barcelona, Catalunya))
Crespo, Marta (Hospital del Mar (Barcelona, Catalunya))
Marco, Ester (Institut Hospital del Mar d'Investigacions Mèdiques)
Rodríguez-Mañas, Leocadio (Hospital Universitario de Getafe (Madrid))
Pascual Santos, Julio (Hospital del Mar (Barcelona, Catalunya))
Universitat Autònoma de Barcelona. Departament de Cirurgia

Date:	2022
Abstract:	Frailty is defined as decreased physiologic reserve and resistance to stressors that predisposes patients towards poor health results. Its prevalence in chronic kidney disease (CKD) patients who are kidney transplant (KT) candidates is high. Frailty is associated with a higher rate of complications and mortality after transplant. It is unknown whether frailty phenotype differs depending on sex in this population. This was a prospective longitudinal study of 455 KT candidates evaluated for frailty by physical frailty phenotype at the time of inclusion on the KT waiting list. Pre-frailty was defined as the presence of two criteria and frailty as three or more criteria. Univariate and multivariate analyses searched for associations of frailty status, frailty components and gender differences. Thirty percent of the total cohort resulted to be pre-frail (20%) or frail (10. 3%), but disparities were observed between sexes, with 22. 5% of men and 47. 2% of women falling into one of these categories. Among frailty criteria, women presented with a higher percentage of exhaustion (39. 6% versus 17%) and slowness (22. 2% versus 9. 6%) compared with men. Comorbidity burden was higher among frail men, whereas social factors were poorer between frail women. Disability was common among those patients who were frail, both men and women. Frailty is twice as frequent in advanced CKD women as men. Frailty criteria distribution and phenotype seem to differ among sexes, which might have implications in terms of specific and individualized interventions to improve their status before transplantation.
Grants:	Instituto de Salud Carlos III PI19/00037
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Frailty ; Gender ; Kidney transplantation ; Risk factor ; Sex
Published in:	Clinical Kidney Journal, Vol. 15 Num. 1(Jan. 2022) , p. 109-118, ISSN 2048-8513

DOI: 10.1093/ckj/sfab133
PMID: 35035941

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