Prospective cohort study reveals persistent metabolic acidosis worsens frailty in kidney transplant recipients, indicating potential intervention need.
Key Points
The study examines the relationship between persistent metabolic acidosis and frailty trajectories after kidney transplantation.
Prospective single-center cohort study with 239 adult kidney transplant recipients followed for 24 months.
Serum bicarbonate levels measured at baseline, 6, 12, and 24 months; persistent acidosis defined by bicarbonate < 22 mmol/L across visits.
Frailty assessed using the Fried phenotype at specified time points, with analyses using mixed-effects ordinal logistic regression.
Frailty prevalence at 24 months was 7.4% for no acidosis and increased to 27.4% for persistent acidosis (p for trend = 0.004).
Each category increase in acidosis persistence was associated with worse frailty odds (unadjusted pOR 1.91, 95% CI 1.42–2.56).
Significant association remained after adjusting for demographics and kidney function (pOR 1.42, 95% CI 1.04–1.95), with higher frailty scores linked to persistent acidosis (β 0.31, p < 0.001).