Frailty, a measure of physiologic reserve, is associated with poor outcomes and mortality among kidney transplant (KT) candidates and recipients. There are no national estimates of frailty in this population, which may help patient counseling and resource allocation at transplant centers. We studied 4616 KT candidates and 1763 recipients in our multicenter prospective cohort of frailty from 2008-2018 with Fried frailty measurements. Using Scientific Registry of Transplant Recipients (SRTR) data (KT candidates = 560 143 and recipients = 243 508), we projected the national prevalence of frailty (for KT candidates and recipients separately) using standardization through inverse probability weighting, accounting for candidate/recipient, donor, and transplant factors. In our multicenter cohort, 13.3% of KT candidates were frail at evaluation; 8.2% of LDKT recipients and 17.8% of DDKT recipients were frail at transplantation. Projected nationally, our modeling strategy estimated 91 738 KT candidates or 16.4% (95% confidence interval [CI] 14.4%-18.4%) of all KT candidates during the study period were frail, and that 34 822 KT recipients or 14.3% (95% CI 12.3%-16.3%) of all KT recipients were frail (LDKT = 8.2%; DDKT = 17.8%). Given the estimated national prevalence of frailty, transplant programs should consider assessing the condition during KT evaluation to improve patient counseling and resource allocation along with identification of recipients at risk for poor outcomes.

中文翻译：

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美国肾移植候选者和接受者的虚弱患病率：来自国家登记和多中心队列研究的估计。


虚弱是衡量生理储备的一种指标，与肾移植（KT）候选者和接受者的不良预后和死亡率相关。全国范围内没有对该人群的虚弱程度进行估计，这可能有助于移植中心的患者咨询和资源分配。我们使用 Fried 衰弱测量方法，对 2008 年至 2018 年多中心前瞻性衰弱队列中的 4616 名 KT 候选者和 1763 名接受者进行了研究。使用移植受者科学登记 (SRTR) 数据（KT 候选者 = 560 143 和受者 = 243 508），我们通过逆概率加权进行标准化，并考虑了候选者/受者，预测了全国衰弱患病率（分别针对 KT 候选者和受者） 、供体和移植因素。在我们的多中心队列中，13.3% 的 KT 候选人在评估时表现虚弱； 8.2% 的 LDKT 接受者和 17.8% 的 DDKT 接受者在移植时身体虚弱。在全国范围内进行预测，我们的建模策略估计研究期间有 91 738 名 KT 候选者或所有 KT 候选者的 16.4%（95% 置信区间 [CI] 14.4%-18.4%）身体虚弱，并且 34 822 名 KT 接受者或 14.3%（95所有 KT 接受者的 % CI（12.3%-16.3%）都很虚弱（LDKT = 8.2%；DDKT = 17.8%）。鉴于估计的全国衰弱患病率，移植计划应考虑在 KT 评估期间评估病情，以改善患者咨询和资源分配，并识别面临不良结果风险的受者。