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Review
. 2023 Dec 30;9(4):791-806.
doi: 10.1016/j.ekir.2023.12.022. eCollection 2024 Apr.

Narrative Review: Clinical Implications and Assessment of Frailty in Patients With Advanced CKD

Alice L Kennard  1   2 , Nicholas J Glasgow  2 , Suzanne E Rainsford  2 , Girish S Talaulikar  1   2
Affiliations
Review

Narrative Review: Clinical Implications and Assessment of Frailty in Patients With Advanced CKD

Alice L Kennard et al. Kidney Int Rep. .

Abstract

Frailty is a multidimensional clinical syndrome characterized by low physical activity, reduced strength, accumulation of multiorgan deficits, decreased physiological reserve, and vulnerability to stressors. Frailty has key social, psychological, and cognitive implications. Frailty is accelerated by uremia, leading to a high prevalence of frailty in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) as well as contributing to adverse outcomes in this patient population. Frailty assessment is not routine in patients with CKD; however, a number of validated clinical assessment tools can assist in prognostication. Frailty assessment in nephrology populations supports shared decision-making and advanced communication and should inform key medical transitions. Frailty screening and interventions in CKD or ESKD are a developing research priority with a rapidly expanding literature base.

Keywords: assessment; communication; frailty; kidney disease; rehabilitation.

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Figure 1
Figure 1
Risk factors, pathophysiological mechanisms, and clinical markers of frailty in the kidney disease context.
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