Comprehensive Geriatric Assessment in Kidney Transplantation

Study Overview
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Brief Summary
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This observational study aims to analyze the results of comprehensive geriatric assessment and to monitor the development of functional status in geriatric kidney transplant candidates and recipients.

Detailed Description
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Kidney transplantation represents the best therapeutical option in patients in end stage kidney disease. At present, increasing number of older patients are referred for kidney transplantation. Patients' functional status has been shown to be associated with transplant outcomes. The comprehensive geriatric assessment (CGA) of functional and mental status in older kidney transplant candidates might play an important and supportive role in the pre-transplant evaluation process, including acceptance for transplantation. In kidney transplant recipients, this examination might be useful to evaluate the impact of pre-transplant status on post-transplant course. Also in KTR, CGA may contribute to the improvement of functional status and quality of life independently from the graft function.

Official Title
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Comprehensive Geriatric Assessment in Kidney Transplantation

Conditions
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Kidney Transplant; Complications, Frailty Syndrome, Depressive Syndrome

Intervention / Treatment
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* Procedure: Functional geriatric assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: kidney transplant candidates aged 60+ years kidney transplant recipients aged 60+ years Exclusion Criteria: kidney transplant candidates aged below 60 years kidney transplant recipients aged below 60 years

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Non-frail<br>Group of patients which will meet the criteria for non-frail according to the result of functional examination. | Procedure: Functional geriatric assessment<br>* Examination of physical and mental status using standardized tests.<br>|
| Pre-frail<br>Group of patients which will meet the criteria for pre-frail according to the result of functional examination. | Procedure: Functional geriatric assessment<br>* Examination of physical and mental status using standardized tests.<br>|
| Frail<br>Group of patients which will meet the criteria for frail according to the result of functional examination. | Procedure: Functional geriatric assessment<br>* Examination of physical and mental status using standardized tests.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frailty syndrome (Fried frailty phenotype) | Geriatric assessment of frailty syndrome in kidney transplant candidates and recipients. Evaluation of frailty syndrome based on Fried frailty phenotype, Short Physical Performance Battery (SPPB) and complex comprehensive geriatric assessment including cognitive frailty (Montreal Cognitive Assessment MoCA). | 2020-2040 | 
| Acceptance for kidney transplantation (Number of patients listed for kidney transplantation and number of transplanted patients) | Acceptance for kidney transplantation based on both geriatric and nephrologic evaluation. Number of patients listed for kidney transplantation,number of transplanted patients and number of patients not accepted for transplantation. | 2020-2040 | 
| Outcomes of kidney transplantation (Graft and patient surival, number of patients with related adverse events) | Outcomes of kidney transplantation based on both geriatric and nephrologic evaluation. Short- and long-term patient and graft survival, graft function, post-transplant related adverse events (infection rate, MACE, death, days of hospitalisation). | 2020-2040 | 
| Functional status evaluated by comprehensive geriatric assessment | Functional status evaluated by comprehensive geriatric assessment in geriatric kidney transplant candidates and recipients including evaluation of mobility (Short Physical Performance Battery, SPPB, walking speed m/s, muscle strenght measured by hand-grip) and cognition (Montreal Cognitive Assessment, MoCA), self-sufficiency and/or dysability (Activities of Daily Living, ADL, Instrumental Activities of Daily Living, IADL). | 2020-2040 | 
| Depressive syndrome (amount of depressive symptoms measured by GDS scale) | Depressive syndrome in geriatric kidney transplant candidates and recipients. amount of depressive symptoms measured by GDS (Geriatric Depression Scale) scale by Yesavage. | 2020-2040 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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kidney transplantation, geriatric, frailty, depression, pretransplant evaluation, comprehensive geriatric assessment, posttransplant