Analysis of Individual Components of Frailty in Simultaneous Pancreas and Kidney, and Solitary Pancreas Transplant Recipients

Parajuli, Sandesh; Odorico, Jon; Breyer, Isabel; Zona, Emily; Aziz, Fahad; Lorden, Heather; Garonzik-Wang, Jacqueline; Kaufman, Dixon; Mandelbrot, Didier

doi:10.1097/txd.0000000000001523

Cited by 1 publication

(2 citation statements)

References 44 publications

(48 reference statements)

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“… 18 , 22 Low HGS and slow gait speed are the most predictive of outcomes. 10 Frailty and malnutrition etiology are closely intertwined and therefore is reasonable to expect similar outcomes for kidney transplant recipients with malnutrition.…”

Section: Discussionmentioning

confidence: 99%

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Pretransplant Malnutrition, Particularly With Muscle Depletion Is Associated With Adverse Outcomes After Kidney Transplantation

Lorden,

Engelken,

Sprang

et al. 2024

Transplantation Direct

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Background. Kidney transplant centers lack consistent diagnostic malnutrition tools. The Academy of Nutrition and Dietetics and American Society of Parenteral Nutrition Adult Malnutrition Criteria (AMC) is the widely accepted and utilized tool by Registered Dietitian Nutritionists (RDNs) to diagnose malnutrition. Methods. In this single-center, retrospective observational study, we evaluated the outcomes of prekidney transplant malnutrition based on Academy of Nutrition and Dietetics and American Society of Parenteral Nutrition AMC, as well as the individual components of the AMC, on posttransplant outcomes including length of stay, delayed graft function (DGF), early readmission, cardiovascular events, acute rejection, death-censored graft failure, and death. Bivariable and multivariable logistic regression models were used to assess the association of malnutrition or its components with outcomes of interest. Results. A total of 367 recipients were included, of whom 36 (10%) were malnourished (23 moderately and 13 severely) at pretransplant evaluation. In adjusted models, pretransplant malnutrition was significantly associated with increased risk for early readmission (adjusted odds ratio 2.86; 95% confidence interval: 1.14-7.21; P = 0.03) and with DGF (adjusted odds ratio 8.33; 95% confidence interval: 1.07-64.6; P = 0.04). Muscle depletion was also associated with an increased risk for readmission and with DGF. Fat depletion and reduced functionality in the adjusted model were only associated with increased risk for readmission. Conclusions. Malnutrition could be an important consideration for selecting kidney transplant recipients because it was associated with poor clinical outcomes. A multidisciplinary approach with the involvement of RDNs to outline a nutrition intervention plan may help mitigate some of the poor outcomes.

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Section: Discussionmentioning

confidence: 99%

“…Also, RDNs assess frailty utilizing a modified Fried Frailty Phenotype as described before. 10 Data collection was completed by four transplant RDNs. Patients were assigned a grade of 0 for the absence of malnutrition, a grade of 1 for moderate malnutrition, and a grade of 2 for severe malnutrition.…”

Section: Data Collection Of Malnutrition Assessmentmentioning

confidence: 99%