Frailty predicts surgical complications after kidney transplantation. A propensity score matched study

Author(s)

Mantovani, Milena dos Santos ^[1] ; de Carvalho, Nyara Coelho ^[1] ; Archangelo, Thomaz Eduardo ^[1] ; Modelli de Andrade, Luis Gustavo ^[2] ; Ferreira Filho, Sebastiao Pires ^[3] ; Cavalcante, Ricardo de Souza ^[3] ; Kawano, Paulo Roberto ^[4] ; Papini, Silvia Justina ^[5] ; Costa, Nara Aline ^[1] ; Monteiro de Barros Almeida, Ricardo Augusto ^[3]

Affiliation

^[1] Univ Estadual Paulista UNESP, Fac Med Botucatu, Botucatu, SP - Brazil

^[2] Univ Estadual Paulista UNESP, Fac Med Botucatu, Dept Clin Med, Botucatu, SP - Brazil

^[3] Univ Estadual Paulista Unesp, Fac Med Botucatu, Dept Doencas Trop & Diagnost Imagem, Botucatu, SP - Brazil

^[4] Univ Estadual Paulista Unesp, Fac Med Botucatu, Dept Urol, Botucatu, SP - Brazil

^[5] Univ Estadual Paulista Unesp, Fac Med Botucatu, Dept Enfermagem, Botucatu, SP - Brazil

• Document type: Journal article
• Source: PLoS One; v. 15, n. 2 FEB 26 2020.
• Web of Science Citations: 0

Abstract

Background and objective Surgical complications after kidney transplantation can lead to catastrophic outcomes. Frailty has been associated with important kidney transplantation outcomes; however, there are no studies assessing this measure of physiological reserve as a specific predictor of surgical complications in this population. Such an assessment was, therefore, the objective of the present study. Methods A total of 87 individuals aged. 18 years who underwent kidney transplantation between March 2017 and March 2018 were included. At the time of admission for kidney transplantation, demographic, clinical, and kidney transplantation data were collected, and the frailty score was calculated according to Fried et al., which comprises five components: shrinking, weakness, exhaustion, low activity, and slowed walking speed. Urological, vascular, and general surgical complications were assessed three months later, or until graft loss or death. The propensity score was used to achieve a better homogeneity of the sample, and new analyses were performed in this new, balanced sample. Results Of the 87 individuals included, 30 (34.5%) had surgical complications. After propensity score matching, the risk of surgical complications was significantly higher among the frail individuals (RR 2.14; 95% CI 1.01-4.54; p = 0.035); specifically, the risk of noninfectious surgical complications was significantly higher among these individuals (RR 2.50; 95% CI 1.11-5.62; p = 0.017). Conclusion The results showed that individuals with some degree of frailty before kidney transplantation were more subject to surgical complications. The calculation of the frailty score for transplant candidates and the implementations of measures to increase the physiological reserve of these patients at the time of kidney transplantation may possibly reduce the occurrence of surgical complications. (AU)

• FAPESP's process: 16/24745-3 - Nutritional status and frailty as predictors of infectious and non-infectious complications in kidney transplant recipients
• Grantee: Ricardo Augusto Monteiro de Barros Almeida
• Support Opportunities: Regular Research Grants