Survey of Spanish nephrologists' opinion on the applicability of Fried's geriatric frailty criteria in patients with end-stage renal disease.

BACKGROUND

Fried described fragility as a biological syndrome in the geriatric population with 5 criteria (exhaustion, unintentional weight loss, low physical activity, slow walking speed, and poor grip strength). This diagnostic method is the most commonly used in patients with ESRD. This study aimed to analyse the opinion of Spanish nephrologists about its applicability in ESRD.

METHODS

A survey adapted from a Delphi used by the Johns Hopkins University School of Public Health was distributed among Spanish nephrologists, with their permission and collaboration, and with the support of the Spanish Society of Nephrology.

RESULTS

Of the 179 respondents, 99.4% felt that frailty is prevalent in ESRD. Involuntary weight loss criterion was considered of little use by 12.5% and exhaustion by 12.6%, with consensus on the usefulness of the other three criteria. New criteria were proposed, including depression (23.5%), dependence (18.8%), cognitive impairment (16.5%), dialysis intolerance (14.1%), and malnutrition (11.8%). Intra-dialysis static pedals (74.9%) and prehabilitation in renal transplant candidates (83.1%) were considered beneficial.

CONCLUSIONS

Unintentional weight loss and exhaustion were the criteria considered least appropriate for defining frailty in patients with ESRD. Future studies would be desirable to assess the applicability of the proposed new criteria and the efficacy of intervention and prehabilitation measures. CLINICAL TRIAL NUMBER: Not applicable.