ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1382

Patient Perspectives on Frailty Status Evaluation During Kidney Transplant Assessment

Session Information

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Wu, Henry HL, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
  • Rushton, Lyndsey, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
  • Biggins, Fiona, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
  • Ahmed, Aimun K., Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
  • Woywodt, Alexander, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, United Kingdom
Background

The concept of frailty garnered attention within nephrology in recent years, given strong associations between frailty status and kidney disease outcomes. There is increased debate on formalizing frailty status evaluation during the early stages of assessment for potential kidney transplant recipients. Studies investigating patient perspectives on frailty and frailty status evaluation during transplant assessment are lacking.

Methods

We conducted a qualitative study using cognitive interviews in English for 25 patients aged 65-85 yrs awaiting initial transplant clinic assessment. The interview enquired on patient understanding of frailty, perspectives on the impact of frailty for transplantation outcomes and whether formalized frailty status evaluation during transplant assessment should be established. An inductive thematic analysis of interviews to identify themes reflecting participants’ awareness, understanding and perspectives of frailty and frailty status evaluation in transplant assessment was performed.

Results

There were 14 Male and 11 Female participants and mean age was 69.6 yrs ± 3.4. Participants were mainly white (n=18) and native English speakers (n=20). 3 prominent themes were identified. 1) Prerequisite awareness of the frailty syndrome and recognition of its strong associations with negative health outcomes. Most participants understood frailty as a composite of declining physical function, reduced ability to perform daily activities and increased comorbidity status. 2) Severe frailty status is associated with older transplant recipients. Many participants felt worsened frailty status is correlated with older age, and older transplant recipients generally do more poorly. 8 participants recognized frailty may be independent of age in which older patients could be fitter transplant candidates compared to younger, frailer patients. 3) Universal support for a formalized screening program to evaluate frailty status during pre-transplant assessment. All participants voiced support, to assist clinical decision-making on determining suitability for transplantation from an early stage.

Conclusion

Patient education initiatives should continue to expand awareness of frailty and its implications in transplantation. Further work is required to determine an optimal approach to formally evaluate frailty status during transplant assessment.

Funding

  • Government Support – Non-U.S.