Introduction:
Frailty is a geriatric syndrome common in chronic kidney disease (CKD). The new 2024 KDIGO guidelines already recommend screening of frailty as a modifier of CKD management. There are several available and validated tools to diagnose frailty.
Methods:
Ninety-two patients (pts) over 65 years old were screened during Nephrology appointment from January to March 2024. Demographic and clinical data was collected. Three frailty scales were performed, and frailty was defined as Fried Frailty Scale (FFI >3), Edmonton Frailty Scale (EFS >8) and Clinical Frailty Scale (CFS>5).
Results:
Mean age was 79,4 (65-93, ±7,79) years-old and 59% were male. Around 35% were institutionalized and median Charlson Comorbidity Index (CCI) was 9,12 (±2,6). The majority had CKD stage 4 (54%), followed by CKD stage 3 (35%) and 5 (11%) according to KDIGO classification of CKD. Mean hemoglobin was 12,2 (±1,75) g/dl and mean serum albumin was 3,6 (±0,43) g/dl. Frailty was identified in 20 patients by FFI, in 15 patients by EFS and in 26 patients by CFS. Indeed, all patients identified by EFS were also identified though FFI and CFS, and 10 patients identified by CFS were not identified by other tools, perhaps because of the subjective nature of this last tool. Highlighting other aspects, polypharmacy was detected in 87% of the patients and the mean number of chronic medications was 9,6. Around 30% admitted feeling depressed and 32% having pain. In our cohort there was no relation between the presence of frailty and lower levels of hemoglobin, albumin, KDIGO stage of CKD or the higher CCI. Not surprisingly, age was a predictor or frailty in this cohort (p<0,005).
Conclusions:
Given its potential of reversibility with proper intervention, frailty screening should be widely used in Nephrology appointment. Each doctor should use the tool that is most comfortable with, knowing that FFI is considered the gold standard but requires time, CFS takes less than one minute to perform and EFS is performed by geriatricians in elderly assessment.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.