Limitations of Fried frailty criteria in kidney transplant recipients with arteriovenous fistulas.

BACKGROUND: Kidney transplant recipients (KTRs) are prone to development of muscle dysfunction and frailty. This study aimed to assess muscle strength and body composition alterations in KTRs, and whether an arteriovenous fistula (AVF) can influence handgrip strength (HGS) results in KTRs. METHODS: One hundred fifty-six KTRs were recruited for the prospective, observational study. Both HGS tests and Timed Up and Go test were carried out. HGS results were analyzed taking into consideration the localization of AVF and hand domination. RESULTS: Impaired mobility was identified in 34% of KTRs, while frailty was suspected in almost 13%. HGS differed in patients with an AVF on dominant arm, and equaled 29.5 (20-42), as compared to patients with no AVF on dominant arm with HGS 38 (28-48), p = 0.044. CONCLUSIONS: Impaired mobility is a common problem in the KTR population. The presence of an AVF influences HGS results. The diagnosis of frailty based on Fried criteria may not be valid in KTRs with an AVF, irrespective of its patency. CLINICAL TRIAL REGISTRATION NUMBER: NCT04478968, https://clinicaltrials.gov/search?term=NCT04478968.