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| Conclusions | References | Potential research directions/considerations |
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| Physical frailty testing such as SPPB and FFP can predict the posttransplant outcomes of individuals diagnosed with CKD. | [3–5, 7–9, 11, 17, 22, 31, 32, 43–65] | (i) Determine the robustness of each frailty metric in comparison to each other
(ii) Determine the ideal timing of frailty assessment and how frailty changes with transplantation
(iii) Determine the impact of physical therapy interventions on frailty and postoperative outcomes |
| Cumulative deficit assessment can identify patients at risk for adverse outcomes after kidney transplantation. | [3, 10, 11, 54] | (i) Determine what frailty testing approach is most effective in predicting posttransplant outcomes in patients with CKD |
| Whether a physical, cumulative deficit, or biomarker approach to frailty is more efficient and effective remains unknown. | [3, 6, 12–14, 66–75] | (i) Assessment of different frailty metrics either combined or separately to determine the ideal approach
(ii) Identify the role each metric would play in the development/improvement in multidisciplinary care programs
(iii) Evaluate frailty in other transplant populations to determine how frailty may be similar or different in nonkidney transplant candidates |
| Prevalence of sarcopenia is increased in patients with CKD compared with the general population. | [16, 18, 20, 43, 76–81] | (i) Determine the robustness of different evaluation methods for sarcopenia
(ii) Identify the most beneficial intervention to reduce the impact of sarcopenia as well as other CKD-related conditions |
| Nutritional status is a controllable contributor to frailty. | [22, 25, 26, 81–88] | (i) Independent evaluations of nutrition in the prevalence of frailty
(ii) Identify the effects of early action nutritional programs/interventions among the CKD population, including but not limited to personally curated diets and vitamin and probiotic supplementation
(iii) Define gut microbiome patterns of frail patients |
| Cognitive impairment is more common in patients with CKD compared with the general population. | [22, 30, 89–95] | (i) Identify how cognitive decline can contribute to other independent frailty elements
(ii) Determine whether interventions to improve cognition pretransplantation can impact postoperative delirium |
| CKD patient populations have an overall lower HRQOL and greater prevalence of depressive symptoms. | [28, 35, 37, 38, 42, 74, 75, 96–100] | (i) Development of mental health therapy interventions that address variables more affected in the HRQOL due to the onset of CKD
(ii) Identify a system of metrics that would be used to measure the effectiveness of different forms of therapy on HRQOL and depressive symptoms
(iii) Determine a form of mental health therapy that is the most effective for specific patient populations |
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