Andrew C Nixon1,2,3, Theodoros M Bampouras4,5, Neil Pendleton6, Sandip Mitra7,8, Ajay P Dhaygude9. 1. Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom, andrew.nixon@lthtr.nhs.uk. 2. Centre for Health Research and Innovation, National Institute of Health Research Lancashire Clinical Research Facility, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom, andrew.nixon@lthtr.nhs.uk. 3. Division of Cardiovascular Sciences, University of Manchester, Manchester, United Kingdom, andrew.nixon@lthtr.nhs.uk. 4. Active Ageing Research Group, University of Cumbria, Lancaster, United Kingdom. 5. Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom. 6. Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom. 7. Manchester Academy of Health Sciences Centre, University of Manchester, Manchester, United Kingdom. 8. Devices for Dignity, National Institute of Health Research MedTech and In-vitro Diagnostics Co-operative, Manchester, United Kingdom. 9. Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom.
Abstract
BACKGROUND/AIMS: Frail patients with chronic kidney disease (CKD) have an increased hospitalisation and mortality rate. However, many popular frailty screening methods have not been validated in patients with CKD. This study evaluates the diagnostic accuracy of several frailty screening methods in patients with CKD G4-5 and those established on haemodialysis (G5D). METHODS: Ninety participants with CKD G4-5D were recruited from Nephrology Outpatient Clinics and 2 Haemodialysis Units between December 2016 and December 2017. Frailty was diagnosed using the Fried Frailty Phenotype. The following frailty screening tests were evaluated: Clinical Frailty Scale, PRISMA-7, CKD Frailty Index, CKD FI-LAB, walking speed, hand grip strength and Short Physical Performance Battery. RESULTS: The mean age of participants was 69 years (SD ±13). One-third of participants were dialysis-dependent. Nineteen (21%) patients were categorised as frail, 42 (47%) as pre-frail and 29 (32%) as robust. Overall, walking speed was the most discriminative measure (AUC 0.97 [95% CI 0.93-1.00], sensitivity 0.84 [95% CI 0.62-0.94], specificity 0.96 [95% CI 0.88-0.99]). The Clinical Frailty Scale had the best performance of the non-physical assessment frailty screening methods (AUC 0.90 [95% CI 0.84-0.97], sensitivity 0.79 [95% CI 0.57-0.91], specificity 0.87 [95% CI 0.78-0.93]). CONCLUSIONS: Walking speed can be used to accurately screen for frailty in CKD populations. If it is not practical to perform a physical assessment to screen for frailty, the Clinical Frailty Scale is a useful alternative.
BACKGROUND/AIMS: Frail patients with chronic kidney disease (CKD) have an increased hospitalisation and mortality rate. However, many popular frailty screening methods have not been validated in patients with CKD. This study evaluates the diagnostic accuracy of several frailty screening methods in patients with CKD G4-5 and those established on haemodialysis (G5D). METHODS: Ninety participants with CKD G4-5D were recruited from Nephrology Outpatient Clinics and 2 Haemodialysis Units between December 2016 and December 2017. Frailty was diagnosed using the Fried Frailty Phenotype. The following frailty screening tests were evaluated: Clinical Frailty Scale, PRISMA-7, CKD Frailty Index, CKD FI-LAB, walking speed, hand grip strength and Short Physical Performance Battery. RESULTS: The mean age of participants was 69 years (SD ±13). One-third of participants were dialysis-dependent. Nineteen (21%) patients were categorised as frail, 42 (47%) as pre-frail and 29 (32%) as robust. Overall, walking speed was the most discriminative measure (AUC 0.97 [95% CI 0.93-1.00], sensitivity 0.84 [95% CI 0.62-0.94], specificity 0.96 [95% CI 0.88-0.99]). The Clinical Frailty Scale had the best performance of the non-physical assessment frailty screening methods (AUC 0.90 [95% CI 0.84-0.97], sensitivity 0.79 [95% CI 0.57-0.91], specificity 0.87 [95% CI 0.78-0.93]). CONCLUSIONS: Walking speed can be used to accurately screen for frailty in CKD populations. If it is not practical to perform a physical assessment to screen for frailty, the Clinical Frailty Scale is a useful alternative.
Authors: Kristen Sgambat; Matthew B Matheson; Stephen R Hooper; Bradley Warady; Susan Furth; Asha Moudgil Journal: Pediatr Nephrol Date: 2019-08-02 Impact factor: 3.714
Authors: Andrew Christopher Nixon; Theodoros M Bampouras; Helen J Gooch; Hannah M L Young; Kenneth William Finlayson; Neil Pendleton; Sandip Mitra; Mark E Brady; Ajay P Dhaygude Journal: BMJ Open Date: 2020-06-22 Impact factor: 2.692
Authors: Hannah M L Young; Daniel S March; Patrick J Highton; Matthew P M Graham-Brown; Darren C Churchward; Charlotte Grantham; Samantha Goodliffe; William Jones; Mei-Mei Cheung; Sharlene A Greenwood; Helen C Eborall; Simon Conroy; Sally J Singh; Alice C Smith; James O Burton Journal: BMJ Open Date: 2020-11-03 Impact factor: 2.692
Authors: Henry H L Wu; Reinier Van Mierlo; George McLauchlan; Kirsty Challen; Sandip Mitra; Ajay P Dhaygude; Andrew C Nixon Journal: Int Urol Nephrol Date: 2021-03-08 Impact factor: 2.370