ArticleJournal of the American Society of Nephrology : JASN2019
Frailty and Changes in Cognitive Function after Kidney Transplantation.
Article in Journal of the American Society of Nephrology : JASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 2 of them syntheses that pooled it.
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Who cites it
83 citing papers in PubMed, 2 syntheses or guidelines pooled it, 127 citations in OpenAlex.
- Understanding frailty across the kidney transplant continuum: a comprehensive systematic review of recent evidence.International urology and nephrology · 2026Pooled it
- Change in frailty status in the 12 months following solid organ transplantation: a systematic review and meta-analysis.Age and ageing · 2025Pooled it
- Cognitive function after kidney transplantation: longitudinal trajectories, associated factors, and clinical outcomes-a systematic review.International urology and nephrology · 2026Review
- The Role of Geriatric Syndromes in Kidney Transplant Decision-Making: A Domain-Based Analysis of Comprehensive Geriatric Assessment in Older Adults.Journal of the American Geriatrics Society · 2026Observational
- Article
- A Digital Health Framework to Assess Glycemia and Physical Activity in Kidney Transplant Candidates: A Pilot Study.Transplantation direct · 2026Article
- Assessing and cataloguing cognitive impairment in older potential kidney transplant patients: key recommendations from the ethical and legal issues working group of ELPAT.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Ambient Air Pollution, Cognitive Impairment, and Dementia Among Older Patients Being Evaluated for Kidney Transplantation.Clinical transplantation · 2025Article
- Cognitive Impairment in CMV Seropositive and CMV Seronegative Deceased Donor Kidney Transplant Recipients.Transplantation direct · 2025Article
- Development of Machine-Learning-Based Models for Detection of Cognitive Impairment in Patients Receiving Maintenance Hemodialysis.European journal of neurology · 2025Observational
- Uremic Toxins, CKD, and Cognitive Dysfunction.Journal of the American Society of Nephrology : JASN · 2025Review
- Cognitive impairment in kidney transplanted patients.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Review
- Care pathways for patients with cognitive impairment and chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Review
- Kidney replacement therapies in the older person: challenges to decide the best option.Clinical kidney journal · 2025Review
- Cognitive impairment in CKD patients: a guidance document by the CONNECT network.Clinical kidney journal · 2025Review
- Association between pre-stroke frailty status and post-stroke cognitive impairment in patients with acute large artery atherosclerotic cerebral infarction.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2025Article
- Frailty in Kidney Disease: A Comprehensive Review to Advance Its Clinical and Research Applications.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025Review
- Frailty and post-transplant adverse outcomes among kidney transplant recipients A systematic review and meta-analysis.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2024Article
- Article
- Increased Blood-Brain Barrier Permeability and Cognitive Impairment in Patients With ESKD.Kidney international reports · 2024Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on byAuthors' Reply.2019
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundRestoration of kidney function after kidney transplant generally improves cognitive function. It is unclear whether frail recipients, with higher susceptibility to surgical stressors, achieve such post-transplant cognitive improvements or whether they experience subsequent cognitive decline as they age with a functioning graft.
methodsIn this two-center cohort study, we assessed pretransplant frailty (Fried physical frailty phenotype) and cognitive function (Modified Mini-Mental State Examination) in adult kidney transplant recipients. To investigate potential short- and medium-term effects of frailty on post-transplant cognitive trajectories, we measured cognitive function up to 4 years post-transplant. Using an adjusted mixed effects model with a random slope (time) and intercept (person), we characterized post-transplant cognitive trajectories by pretransplant frailty, accounting for nonlinear trajectories.
resultsOf 665 recipients (mean age 52.0 years) followed for a median of 1.5 years, 15.0% were frail. After adjustment, pretransplant cognitive scores were significantly lower among frail patients compared with nonfrail patients (89.0 versus 90.8 points). By 3 months post-transplant, cognitive performance improved for both frail (slope =0.22 points per week) and nonfrail (slope =0.14 points per week) recipients. Between 1 and 4 years post-transplant, improvements plateaued among nonfrail recipients (slope =0.005 points per week), whereas cognitive function declined among frail recipients (slope =-0.04 points per week). At 4 years post-transplant, cognitive scores were 5.8 points lower for frail recipients compared with nonfrail recipients.
conclusionsOn average, both frail and nonfrail recipients experience short-term cognitive improvement post-transplant. However, frailty is associated with medium-term cognitive decline post-transplant. Interventions to prevent cognitive decline among frail recipients should be identified.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.