Research On The Debilitating Status And Related Factors Of Kidney Transplant Recipients

Objective:(1)To describe the incidence of frailty among renal transplant recipients.(2)To explore the demographic characteristics.disease characteristics and social psychological characteristics related to the frailty of renal transplant recipients.Methods:This paper employed a cross-sectional design.The investigation was conducted in one of the best-rated hospitals in China from June 2019 to October 2019 by convenience sampling.A total of 192 kidney transplant recipients were investigated by asking them to fill out a self-designed general questionnaire,the Chinese version of Tilburg Frailty Indicator(TFI),Frail Scale,Charlson Comorbidity Index(CCI),Pittsburgh Sleep Quality Index,Hospital Anxiety and Depression Scales,the Connor-Davidson Resilience Scale and Perceived Social Support Scale.Data were analysed by using SPSS Version 26.0,including descriptive analysis,spearman correlation analysis and multivariate analysis.For all analyses,a P value set at<0.05 was determined as statistically significant.Results:(1)The median frailty score of 192 renal transplant recipients was 3(2,6),ranging from 0 to 12.The score of physical frailty dimension was 2(1,3),psychological frailty dimension was 1(0,3),and social frailty dimension was 1(0,1).The five most frequently occurring indicators were frequent physical tiredness(52.6%),memory loss(45.8%),poor social relationships(45.8%),anxiety(44.3%)and depression(44.3%)among renal transplant recipients.Seventy-nine recipients were diagnosed with frailty(? 5 points)by Chinese TFI,and the frailty incidence in the renal transplant recipients in this study was 41.1%.Among the 79 frail recipients,the top five severe frail indicators were frequent physical tiredness(86.1%),anxiety(77.2%),depression(77.2%).memory loss(75.9%)and vision problems(64.6%).(2)Univariate analysis showed that the factors related to frailty were employment status,education levels,economic burden,dialysis types,exercise status,total protein and CCI scores(P<0.05).Unemployment,high school education or less,heavy economic burden,hemodialysis and peritoneal dialysis,irregular exercise,abnormal levels of total protein,and comorbidity are risk factors for frailty.Age.time after transplantation,sleep quality score.anxiety score and depression score were significantly positively correlated with frailty score(r=0.144?0.453.<0.05),while resilience score and social support score were significantly negatively correlated with frailty score(r=-0.344?-0.252,P<0.001).(3)Multivariate analysis showed that employment status,economic burden,dialysis types,sleep quality,comorbidity,resilience and anxiety entered the final multiple regression equation and accounted for 45.7%of the total frailty variation(R2=0.457,F=17.05,P<0.001).Higher anxiety and sleep quality scores suggest increased frailty,and low resilience scores suggest improved frailty.Recipients with self-perceived heavy economic burden,hemodialysis and peritoneal dialysis,and non-comorbidity had more severe frailty.Conclusion:(1)The incidence of frailty in renal transplant recipients was 41.1%,which was at a high level.Frequent physical tiredness,memory loss,poor social relationships,anxiety and depression were the most common frail indicators in renal transplant recipients.Frequent physical tiredness,anxiety,depression,memory loss and vision problems are common components in seventy-nine frail recipients.(2)Older,unemployment,at least a senior high school degree,heavy economic burden,longer transplant period,hemodialysis and peritoneal dialysis,worse sleep quality,comorbidity,unnormal total protein,irregular exercise,anxiety,depression,low resilience and low social support were risk factors for frailty in renal transplant recipients.(3)unemployment,heavy economic burden,preoperative combination of hemodialysis and peritoneal dialysis,poor sleep quality,comorbidity,low resilience and anxiety symptoms were the main risk factors for frailty.