Factors associated with frailty in kidney transplant recipients: A cross-sectional study

Background: Frailty is prevalent in kidney transplant recipients and associated with multiple health care challenges. The association between frailty and outcomes has been extensively studied in kidney transplant recipients, but the status of frailty and its associated factors are not well studied, hindering efforts to develop strategies to improve care and reduce frailty. Objectives: To identify the factors that are associated with frailty in kidney transplant recipients comprehensively. Design and Participants: The associated factors of frailty were explored by a cross-sectional study of 185 kidney transplant recipients. Measurements: Data were collected using the general information questionnaire, the Charlson comorbidity index, the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Connor-Davidson Resilience Scale, the Perceived Social Support Scale and the Tilburg Frailty Indicator. Data were analyzed using the multiple linear regression analysis. Results: A total of 75 (40.5%) kidney transplant recipients were assessed as frail by Chinese TFI. Age (beta = 0.228), time post-transplant (beta = 0.055), sleep quality (beta= 0.224) and psychological resilience (beta = -0.038) entered the final multiple regression equation and accounted for 41.8% of the total frailty variation (R2 = 0.418, F = 21.31, p < 0.05). Conclusions: Frailty was common among kidney transplant recipients. Old age, long time after transplantation, poor sleep quality and low psychological resilience were main associated factors for frailty. Integrated care interventions are therefore needed for this vulnerable population to prevent or delay frailty.