Frailty and post-transplant adverse outcomes among kidney transplant recipients: A systematic review and meta-analysis.

IF 1.9 4区医学 Q3 UROLOGY & NEPHROLOGY

Cuaj-Canadian Urological Association Journal Pub Date : 2024-06-17 DOI:10.5489/cuaj.8236

Yanqiu Wang, Jingli Kou, Ludan Xu, Shuao Tang, Mengyao Wei, Binru Han

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引用次数: 0

Abstract

Introduction: Frailty is a good predictor of adverse outcomes among older patients, especially those who have undergone surgery. The prevalence of frailty among kidney transplant candidates is higher than the general population. This study aimed to explore the predictive value of frailty on post-transplant adverse outcomes among kidney recipients.

Methods: A systematic review was performed for relevant studies until May 20, 2022, using four databases (Embase, Medline, Cochrane, and PsycINFO) for prospective design studies (PROSPERP: CRD42022331022). Random-effect meta-analysis modeling was undertaken in RevMan 5.3 to estimate the predicting value of frailty on adverse outcomes after kidney transplant.

Results: This systematic review included 14 studies, eight of which were suitable for meta-analysis. Frailty increased the risk of mortality (pooled hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.48-2.64), surgical complications (risk ratio [RR] 2.14, 95% CI 1.01-4.54), death-censored graft failure (DCGF) (pooled HR 3.31, 95% CI 1.27-8.62), length of stay (LOS) (pooled RR 1.59, 95% CI 1.05-2.39), length of stay ≥2 weeks (pooled odds ratio [OR] 1.72, 95% CI 1.26-2.35). and other common adverse outcomes among kidney transplant recipients.

Conclusions: Frailty is associated with adverse outcomes after kidney transplant. This systematic review suggests the importance of assessing frailty among kidney transplant candidates prior to transplantation. Further research focusing on pretransplant assessment combined with frailty is warranted to improve kidney transplant management.

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肾移植受者的虚弱与移植后不良预后：系统回顾和荟萃分析。

简介虚弱是老年患者，尤其是接受过手术的患者出现不良预后的一个很好的预测因素。肾移植患者中体弱的发生率高于普通人群。本研究旨在探讨虚弱对肾移植受者移植后不良预后的预测价值：使用四个数据库（Embase、Medline、Cochrane和PsycINFO）对2022年5月20日之前的相关研究进行了系统性回顾，以了解前瞻性设计研究（PROSPERP：CRD42022331022）。在RevMan 5.3中进行了随机效应荟萃分析建模，以估计虚弱对肾移植后不良结局的预测价值：本系统综述共纳入 14 项研究，其中 8 项适合进行荟萃分析。虚弱增加了死亡率（合并危险比 [HR] 1.98，95% 置信区间 [CI] 1.48-2.64）、手术并发症（风险比 [RR]2.14，95% CI 1.01-4.54）、死亡剪除移植物失败（DCGF）（合并危险比 3.31，95% CI 1.27-8.62）、住院时间（LOS）（风险比[RR]1.59，95% CI 1.05-2.39）、住院时间≥2周（风险比[OR]1.72，95% CI 1.26-2.35）：结论：虚弱与肾移植后的不良预后有关。本系统综述表明，在移植前评估肾移植候选者的虚弱程度非常重要。有必要进一步研究移植前评估与虚弱程度的结合，以改善肾移植管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cuaj-Canadian Urological Association Journal 医学-泌尿学与肾脏学

CiteScore

2.80

自引率

10.50%

发文量

167

审稿时长

>12 weeks

期刊介绍： CUAJ is a a peer-reviewed, open-access journal devoted to promoting the highest standard of urological patient care through the publication of timely, relevant, evidence-based research and advocacy information.