A Snapshot View of Sarcopenia and Frailty Status in Kidney Transplant Recipients

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INTRODUCTION: Sarcopenia, defined as loss of skeletal muscle mass and function, often progresses to frailty and is associated with unfavorable post-transplant outcomes. Frailty is characterized by diminished physiological capacity and increased vulnerability. On the other hand, kidney transplantation is associated with lower mortality rates and improved quality of life. The aim of this study is to determine the prevalence of frailty status using two different methods in kidney transplant (KT) recipients, to investigate the relationship between sarcopenia and frailty status, and to identify factors that influence both conditions. METHODS: We included 123 KT recipients who were admitted to the transplant outpatient clinic between March 2024 and July 2024. EWGSOP2 criteria were used to diagnose sarcopenia. Modified Fried's Frailty Phenotype criteria and FRAIL scale were used to assess frailty. RESULTS: Mean age was 49±12 years and 45.5% were female. Overall, 32.5% and 4.9% of patients were identified as probable sarcopenic and sarcopenic, consecutively. The number of patients with deceased transplantation was higher in sarcopenic patients (p = 0.004). When grouped according to Modified Fried's Frailty Phenotype 41.5% of patients were prefrail and 4.1% were frail. According to FRAIL scale, 28.5% of participants were prefrail, and 3.3% were frail. Two scales showed substantial agreement. Serum phosphorus was higher in the frail and prefrail patient groups according to both frailty scales compared to robust group (p<0.001, p = 0.04). CONCLUSIONS: Pre-frailty and sarcopenia are common in KT recipients and are associated with higher serum phosphorus. Notably, sarcopenia was linked to having a deceased donor transplantation, underscoring the importance of targeted screening and management in this population.

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