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Frailty Screening in Chronic Kidney Disease: Current Perspectives

Authors Worthen G, Tennankore K

Received 28 August 2019

Accepted for publication 21 November 2019

Published 5 December 2019 Volume 2019:12 Pages 229—239


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Pravin Singhal

George Worthen,1 Karthik Tennankore2

1Department of Medicine, Nova Scotia Health Authority, Halifax, NS, Canada; 2Division of Nephrology, Nova Scotia Health Authority, Halifax, NS, Canada

Correspondence: Karthik Tennankore
Division of Nephrology, QEII - Dickson Building, Suite 5090 Dickson Building, 5820 University Avenue, Halifax, NS B3H 2Y9, Canada
Tel +1 902-473-2099
Fax +1 902-473-2675

Abstract: Frailty has been defined as a state of increased vulnerability as a consequence of deficit accumulation. Frailty screening has not yet been widely implemented into routine nephrology care. Patients with chronic kidney disease (CKD) are at high risk of being frail, and frailty has been associated with worse outcomes in this population. Standard management of CKD, including initiation of renal replacement therapies, may have decreased benefit or potentially cause harm in the presence of frailty, and a variety of interventions for modifying frailty in the CKD population have been proposed. The optimal means of screening for frailty in patients with kidney disease remains unclear. This review highlights the value of frailty screening in CKD by summarizing the outcomes associated with frailty and exploring proposed changes to the management of frail patients with CKD. Finally, we will propose a framework for how to implement frailty screening into standard nephrology care.

Keywords: geriatrics, sarcopenia, transplant, dialysis, conservative management

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