Change in Frailty Status Over Time Among In-Center Hemodialysis ESRD Patients in the ACTIVE/ ADIPOSE Study

B. Tao, J. Gander, N. Kutner, S. Pastan, R. Zhang, R. Patzer.

Emory University, Atlanta, GA.

Meeting: 2015 American Transplant Congress

Abstract number: B228

Keywords: Outcome, Quality of life, Renal dysfunction, Waiting lists

Session Information

Session Name: Poster Session B: Obesity/Elderly/Frail

Session Type: Poster Session

Date: Sunday, May 3, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Introduction: Frailty among End Stage Renal Disease (ESRD) is associated with poor health outcomes, including delayed graft function and hospitalization following transplantation. Although frailty is prevalent among ESRD patients, little is known about change in patients' frailty status over time, including once waitlisted for transplantation.

Methods: The ACTIVE/ADIPOSE study is a nationwide, multicenter, prospective cohort study measuring frailty among ESRD patients. The study collected components of the Fried Frailty Index (non-frail, pre-frail, or frail) and Kidney Disease Quality of Life (KDQOL) among 742 in-center hemodialysis patients at baseline, 12-month and 24-month follow-up from 2009 to 2013. There were 283 patients lost to follow-up; 459 patients had complete follow-up data and were included in this study. Reasons for loss to follow-up were similar across the three frailty groupings, including death, transfer to another facility and modality changes. Patients' frailty status over the study period was compared to their baseline frailty status for the overall study population and waitlisted patients, respectively.

Results: Among the 459 participants with complete follow-up, 54 (11.8%) were classified as frail and 270 (58.8%) were classified as pre-frail at baseline. Among patients classified as frail at baseline, 50.0% were classified as pre-frail and 3.7% were classified as non-frail at the 24-month follow-up visit (Fig1). Among patients classified as pre-frail at baseline, 17.8% were classified as frail and 20.7% were classified as non-frail at 24-months. Among non-frail patients at baseline, 43.7% were classified as pre-frail and 5.9% were classified as frail at 24-months. Similar results were found among waitlisted vs. non-waitlisted patients.

Conclusion: In this study, change in the frailty status of in-center hemodialysis patients was observed over time. Further investigation is required to evaluate factors associated with these changes, and whether longitudinal measurements rather than single cross-sectional measures of frailty may be more informative indicators of pre- and post-transplant outcomes among ESRD patients.

To cite this abstract in AMA style:

Tao B, Gander J, Kutner N, Pastan S, Zhang R, Patzer R. Change in Frailty Status Over Time Among In-Center Hemodialysis ESRD Patients in the ACTIVE/ ADIPOSE Study [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/change-in-frailty-status-over-time-among-in-center-hemodialysis-esrd-patients-in-the-active-adipose-study/. Accessed May 19, 2025.

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