The average age of the world population is increasing, leading to a rise in chronic diseases such as hypertension and diabetes, which are major causes of end-stage kidney disease (ESKD). As a result, the prevalence of ESKD has significantly increased, and the number of older adults eligible for kidney transplantation is growing. Frailty and body composition are becoming increasingly important in assessing transplant eligibility, as biological age may be a better predictor of outcomes than chronological age.
This dissertation of Evelien Elisabeth Quint explores the impact of frailty and body composition on kidney transplant outcomes and how these can be improved through prehabilitation. It consists of three parts: the first part addresses the prevalence and impact of frailty, the second part examines the relationship between body composition and clinical outcomes, and the third part focuses on strategies such as prehabilitation to improve outcomes.
Key findings include that frailty is common among kidney transplant patients and is associated with poorer outcomes, such as longer hospital stays. It was also found that abnormal body composition, such as sarcopenia and myosteatosis, increases the risk of mortality. Prehabilitation, aimed at improving the physical and mental condition of patients prior to transplantation, appears to be a promising approach to enhance outcomes.
The dissertation emphasizes the importance of a more personalized approach to care, where risk factors such as frailty and body composition are addressed early to optimize kidney transplant outcomes.
