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Abstract: PO0823

Evaluation of Frailty Assessment Tools and Their Measurement Properties in CKD

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Puri, Alisha, University of Alberta Department of Medicine, Edmonton, Alberta, Canada
  • Bello, Aminu K., University of Alberta Department of Medicine, Edmonton, Alberta, Canada
  • Thompson, Stephanie E., University of Alberta Department of Medicine, Edmonton, Alberta, Canada
  • Tandon, Puneeta, University of Alberta Department of Medicine, Edmonton, Alberta, Canada
  • Campbell, Sandra M., University of Alberta Department of Medicine, Edmonton, Alberta, Canada
  • Lloyd, Anita, University of Alberta Department of Medicine, Edmonton, Alberta, Canada
Background

Frailty is three to seven times more common in people with chronic kidney disease (CKD) than in those with normal kidney function. Although frailty and its impact in CKD is well-recognized, the measurement properties of the tools used to assess this syndrome are not known. The aim of this systematic review was to evaluate frailty assessment tools and their measurement properties in CKD.

Methods

The study was conducted using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines and Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols (PRISMA-P 2015). We searched ten electronic databases (eg. OVID MEDLINE, OVID EMBASE, OVID Health and Psychosocial Instruments, Cochrane Central Register of Controlled Trials (CENTRAL)) and screened studies as per the following inclusion criteria: peer-reviewed original research, adults with CKD (non-dialysis, dialysis or kidney transplant (KT)), examines at least one established multidimensional tool used for the assessment of frailty, and presents information to evaluate the measurements properties of the tool. Methodological quality assessment and data synthesis will be performed as per COSMIN guidelines. This review was registered with PROSPERO (CRD42021234558).

Results

We retrieved 647 unique citations with 58 eligible studies (N=16,026) of which 60% were prospective cohort studies. The majority (59%) included patients on dialysis, 19% were KT, and the remaining non-dialysis CKD. The dialysis populations utilized hemodialysis (HD) (38%) and peritoneal dialysis (PD) (34%) modalities. Fried’s phenotype was the most commonly tool used to assess frailty (57%). Predictive validity was the most frequently reported measurement property (86%) followed by responsiveness (12%). Thirty-one (53%) of the included studies using the Fried’s Phenotype evaluated predictive validity.

Conclusion

In this review, a majority of the studies focused on the dialysis and non-dialysis populations. Fried’s Phenotype, the most commonly administered tool, primarily evaluated predictive validity. Future research is required to identify the tool(s) that will be predictive of adverse health outcomes in the KT population and additional studies evaluating these tool’s responsiveness to change are needed.