Frailty Prevalence in Younger ESKD Patients Undergoing Dialysis and Transplantation

BACKGROUND: Frailty, originally characterized in community-dwelling older adults, is increasingly being studied and implemented for adult patients with end-stage kidney disease (ESKD) of all ages (>18 years). Frailty prevalence and manifestation are unclear in younger adults (18–64 years) with ESKD; differences likely exist based on whether the patients are treated with hemodialysis (HD) or Kidney Transplantation (KT). METHODS: We leveraged three cohorts: 378 adults initiating hemodialysis (HD) (2008–2012), 4,304 adult kidney transplantation (KT) candidates (2009–2019), and 1,396 KT recipients (2008–2019). The frailty phenotype was measured within 6-months of dialysis initiation, at KT evaluation, and KT admission, respectively. Prevalence of frailty and its components was estimated by age (≥65vs.0.1). Similar results were observed for recipients and HD patients. CONCLUSIONS: Although frailty prevalence increases with age, younger patients have a high burden. Clinicians caring for this vulnerable population should recognize that younger patients may experience frailty, and screen all age groups.