Frailty and Dependency in Kidney Transplant Candidates

Objective: Frailty is very common in kidney disease, and most of the end-stage kidney disease patients are described as frail. This study aimed to define frailty condition in kidney transplant candidates and investigate its relationship between dependency and laboratory parameters. Methods: One hundred two end-stage kidney disease patients on deceased kidney transplant waiting list were included in the study. Modified Fried Frailty Index and FRAIL frailty questionnaire were used to assess frailty and Activities of Daily Living scale and Instrumental Activities of Daily Living scale to assess functional dependency in kidney transplant candidates. Results: The patients' mean age was 49.09 +/- 13.77 years. According to the Modified Fried Frailty Index, 30.4% of patients were non-frail, 48.0% were pre-frail, and 21.6% were frail. According to the FRAIL scale, 34.3% of patients were non-frail, 40.2% were pre-frail, and 25.5% were frail. C-reactive protein level was found to be higher in frail and pre-frail patients (P=.049; P = .010). Frailty increased with age. According to the Activities of Daily Living scale 15 (14.7%) of the patients and according to the Instrumental Activities of Daily Living scale 27 (26.5%) of the patients were dependent. It was observed that frail patients were more dependent on Activities of Daily Living scale and Instrumental Activities of Daily Living scale (P< .001). Multivariate regression analyses revealed C-reactive protein and Activities of Daily Living scale are independent predictors of frailty. Conclusion: In our study, we found that frailty increased with age, with C-reactive protein levels as a marker of inflamma-tion, and it had a negative impact on the Activities of Daily Living scale affecting daily life to a statistically significant degree.