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Frailty in Focus: A Scoping Review of Frailty Instruments from the Kidney Disease Aging Research Collaborative
Devika Nair1,2,3,4, Ilana Mittleman5, Juliana Magro6
1Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee.
Clinical Journal of the American Society of Nephrology : CJASN
|January 21, 2026
Summary
Frailty assessment in kidney disease is crucial. The Clinical Frailty Scale (CFS) shows strong validity, but may overestimate frailty prevalence compared to the Physical Frailty Phenotype (PFP).
Area of Science:
- Nephrology
- Geriatrics
- Psychometrics
Background:
- Frailty is a significant predictor of adverse outcomes in kidney disease.
- Limited understanding of psychometric properties of frailty instruments beyond the Physical Frailty Phenotype (PFP).
Purpose of the Study:
- To critically appraise the validity and reliability of frailty instruments in kidney disease populations.
- To identify knowledge gaps in frailty assessment within the kidney disease continuum.
Main Methods:
- Systematic literature search following PRISMA-ScR guidelines across multiple databases.
- Inclusion of studies applying validated frailty instruments (excluding PFP) in kidney disease patients.
Main Results:
- 136 articles identified; Clinical Frailty Scale (CFS), FRAIL Scale, and Edmonton Frail Scale were most common.
- Most instruments showed predictive validity for mortality and hospitalizations.
- CFS demonstrated strong validity but may lead to higher frailty prevalence estimates than PFP.
Conclusions:
- CFS is a valid instrument for frailty assessment in kidney disease, apart from PFP.
- Further research needed on feasibility, psychometric properties in diverse kidney disease populations, and inclusion of psychosocial/physiological markers.
Keywords:
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