*Purpose: Frailty is a medical syndrome characterized by reduced physiologic function and strength. It is associated with an increased risk of mortality, hospital readmission and delayed graft function. High frailty scores reduce the chances of listing for kidney transplantation and therefore access to transplant. In this study, we examine the feasibility of the routine assessment of frailty in a veteran dialysis patient population. In doing so, we will understand what barriers exist to the routine assessment of frailty and what frailty metrics can be improved through interventions. In order to increase access to transplantation it is important to identify frailty in the hemodialysis population and intervene as deemed appropriate.

*Methods: All eligible patients will be evaluated with the John Hopkins Frailty score. Frailty is defined as the presence of three or more of the five physical frailty criteria- weight loss, weakness (grip strength), self-reported exhaustion, slow walking speed and low physical activity. Veterans 50 years or older receiving hemodialysis at the Hines VA dialysis unit were evaluated for frailty with standardized protocols. Exclusion criteria include advanced cardiovascular disease and limited mobility.

*Results: 23/79 (29%) patients on chronic hemodialysis at the Hines VA Hospital underwent frailty assessment. Average age for our cohort was 71.7 years (+/- 9 years). Average Frailty scores was 2.56 (+/- 1.53). The pre-frail and frail cohorts (Frailty 2-5) were older than the non-frail cohorts (64.7 years vs. 75.8 years; p=0.01). Cohorts that scored “0” were younger those that scored “1” (63.8 years vs. 79 years; p=0.02). Correlation analysis revealed that there was a 60% chance of increasing frailty with age amongst our population.

*Conclusions: Frailty is an important factor in deciding transplantation candidacy and Frailty >3 is associated with worse transplant outcomes. In our elderly dialysis population, average frailty scores resulted in a “pre-frail” to “frail” assessment. Frailty was correlated with age, however there were significant differences even at low frailty scores. In our ongoing trial, eligible veterans who meet frailty score ≥3 will be invited to participate in a veteran designed intervention to improve frailty and hence increase access to transplant and improve posttransplant outcomes.

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