AUTHOR=Pérez-Sáez María José , Melilli Edoardo , Arias Marta , Franco Antonio , Martínez Rocío , Sancho Asunción , Molina María , Facundo Carme , Polanco Natalia , López Verónica , Mazuecos Auxiliadora , Cabello Sheila , González García María Elena , Suárez María Luisa , Auyanet Ingrid , Espi Jordi , García Falcón Teresa , Ruiz Juan Carlos , Galeano Cristina , Artamendi Marta , Rodríguez-Ferrero María Luisa , Portolés José María , Santana María Auxiliadora , Martín-Moreno Paloma Leticia , Arhda Nisrine , Calvo Marta , Mendiluce Alicia , Macía Manuel , Pérez-Tamajón María Lourdes , de Teresa Javier , Gascó Blanca , Soriano Sagrario , Tabernero Guadalupe , de la Vara Lourdes , Ramos Ana María , Martínez Rafael , Montero de Espinosa Enrique , Zalve José Luis , Pascual Julio , Rodríguez-Mañas Leocadio , Gutiérrez-Dalmau Alex , Moreso Francesc 

TITLE=Frailty Prevalence and Characterization Among Kidney Transplant Candidates in Spain: A Multicenter Study

JOURNAL=Transplant International

VOLUME=Volume 38 - 2025

YEAR=2025

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2025.14098

DOI=10.3389/ti.2025.14098

ISSN=1432-2277

ABSTRACT=Frailty is a frequent condition among kidney transplant candidates (KTc) that confers poor outcomes after transplantation. We aimed to establish frailty prevalence in a representative sample of KTc in Spain. We conducted a multicenter cross-sectional study including 1194 KTc ≥50 years. Frailty was assessed by the FRAIL scale. Mean age was 64.2 years; 38.4% were female. Median Charlson comorbidity index (CCI) was 6 [4–7] and the total number of medications was 9 [7–12]. We found that 8.2% of patients were frail and 41.5% were pre-frail. Frailty was more frequent among females (60.2% of frail vs. 32.8% of robust; p < 0.001), hemodialysis patients (74.5% of frail vs. 67.1% of robust; p = 0.02), and those with a high burden of disease (54.6% of frail patients with CCI >6 vs. 29.3% of robust; p < 0.001). The multivariable analysis confirmed that frailty was associated with the female sex (OR 3.9 [2.5–6.2]); higher CCI (>6 OR 2.9 [1.6–54]); and the number of medications (OR –per medication- 1.13 [1.07–1.2]). Almost 50% of KTc in Spain are pre-frail or frail. Frailty is more prevalent between women and patients with high comorbidity burden. Identifying those candidates at risk is essential to establish risks and implement strategies to minimize them.