Frailty in people with advanced chronic kidney disease (CKD) attending a kidney supportive care (KSC) service

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Hepburn, Kirsten
Purtell, Louise
Austin, Laura
Berquier, Ilse
Kramer, Katrina
Bonner, Ann
Healy, Helen
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2022
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Sydney, Australia

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Abstract

Background: Frailty is a multidimensional syndrome where physiological decline leads to increased vulnerability to adverse health outcomes. Frailty can be difficult to assess, but is common in people with CKD. The Clinical Frailty Scale (CFS), is a simple, albeit, subjective tool with significance as a predictor for mortality in CKD.

Aim: To examine frailty, using the CFS, in people attending a KSC clinic over a 10-month period.

Methods: Retrospective analysis of people attending KSC clinics between 1st July 2021 and 30th April 2022. Demographics, disease data, Charlson Comorbidity index (CCI), Resource Utilization Group Activities Daily Living (RUG-ADL), Australia-modified Karnofsky Performance Status (AKPS), and treatment pathway, were extracted from clinical records. Medical and nursing staff rated frailty from 1 to 9 using the CFS. Results were analysed descriptively and group differences tested using the Mann–Whitney U test.

Results: The CFS was recorded for 240 people at 366 KSC attendances. Median age was 79.6 years (IQR 13.1 years), 43.8% were female, median eGFR was 16 ml/min/1.73 m2 (IQR 9 ml/min/1.73 m2) and 26% were on kidney replacement therapy (KRT). Average CCI was 6.9 (SD 2.0), median RUG-ADL 4 (IQR 1) and median AKPS 60 (IQR 10). Median CFS was 4 (IQR 2), representing very mild frailty. There was no significant difference in CFS between people on conservative and KRT pathways (p = 0.11), with median CFS of 5 (IQR 2) and 4 (IQR 2), respectively.

Conclusion: Surprisingly, this study cohort were, in general, only rated as having very mild frailty using the CFS. Frailty was similar in people on conservative and KRT pathways. Selection bias may have contributed to these findings. Further longitudinal studies are required to understand frailty in the KSC population.

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Nephrology

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27

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S1

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Clinical sciences

Life Sciences & Biomedicine

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Urology & Nephrology

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Hepburn, K; Purtell, L; Austin, L; Berquier, I; Kramer, K; Bonner, A; Healy, H, Frailty in people with advanced chronic kidney disease (CKD) attending a kidney supportive care (KSC) service, Nephrology, 2022, 27 (S1), pp. 88-88