Related Experiment Video
Updated: Jun 20, 2025
Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Usefulness of the Clinical Frailty Scale in patients with end-stage kidney disease
Kyra Lamberink1, Yolande M Vermeeren1, Arthur D Moes1
1Department of Internal Medicine, Gelre Hospitals, Apeldoorn, The Netherlands.
Background:
The frailty index (FI) is commonly used to estimate frailty in end-stage kidney disease (ESKD) patients. The Clinical Frailty Scale (CFS) is a less time-consuming alternative. We aimed to determine the test performance of the CFS for pre-dialysis and dialysis patients and patients receiving conservative therapy from the Dialysis Centre Apeldoorn.
Methods:
In this cross-sectional study, haemodialysis, peritoneal dialysis, pre-dialysis patients and patients receiving conservative therapy from the Dialysis Centre Apeldoorn were included and subjected to frailty assessment. Nephrologists not familiar with the CFS completed the frailty score after medical consultation. The sensitivity, specificity and area under the curve (AUC) of the CFS were determined. The FI was used as the gold standard.
Results:
Included were 144 patients, of whom 60 (41.7%) were considered frail according to the FI. The mean age was 67.4 ± 13.5 years and 56 (38.9%) were female. The cut-off point of the CFS for 'vulnerable' (CFS ≥4) had a sensitivity of 63.3%, a specificity of 81.0% and an AUC of 0.72. The cut-off point of the CFS for 'frail' (CFS ≥5) had a sensitivity of 50.0%, a specificity of 91.7% and an AUC of 0.71.
Conclusions:
The CFS is a quick and easy-to-use tool for the determination of frailty in ESKD patients with a high prevalence of frailty. Nevertheless, the sensitivity of the CFS in the present study was considered too low to implement into daily clinical practice. The sensitivity might be increased by training nephrologists in the use of the CFS.
Related Concept Videos
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:23Renal Clearance
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...