Evidence map›Paper›PMID 32640462›Full record

Observational studyAmerican journal of nephrology2020

Frailty Prevalence in Younger End-Stage Kidney Disease Patients Undergoing Dialysis and Transplantation.

Nadia M Chu, Xiaomeng Chen, Silas P Norman, Jessica Fitzpatrick, Stephen M Sozio, Bernard G Jaar, Alena Frey, Michelle M Estrella, Qian-Li Xue, Rulan S Parekh and 2 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in American journal of nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  19. Frailty in Kidney Disease: A Comprehensive Review to Advance Its Clinical and Research Applications.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Nadia M ChuDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Xiaomeng ChenDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Silas P NormanDivision of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Jessica FitzpatrickChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
Stephen M SozioDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Bernard G JaarDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Alena FreyDepartment of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Michelle M EstrellaKidney Health Research Collaborative, Department of Medicine, University of California, San Francisco and Department of Medicine, San Francisco VA Medical Center, San Francisco, California, USA.
Qian-Li XueDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Rulan S ParekhChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
Dorry L SegevDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Mara A McAdams-DeMarcoDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA, mara@jhu.edu.

Funding

Technological Assessment and Solutions Core - RC4P30AG021334 · NIA · JOHNS HOPKINS UNIVERSITY · PI Jeremy D Walston · 2003 to 2026
$33.2M
Kidney transplantation in older, frail and cognitively impaired adults with ESRD: Balancing utility vs. justiceR01AG055781 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2017 to 2021
$4.2M
Hemodialysis-based interventions to preserve cognitive functionR01DK114074 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2018 to 2022
$3.9M
Longitudinal Study of DialysisR01DK072367 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI PAREKH, RULAN S · 2007 to 2011
$3.7M
Patient Oriented Research in Solid Organ TransplantationK24AI144954 · NIAID · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI SEGEV, DORRY L. · 2020 to 2024
$956k
Patient Oriented Research in Kidney Disease and Transplant SurgeryK24DK101828 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2014 to 2018
$922k
Frailty, Post-Transplant Delirium, and Neurocognitive Underpinnings of AlzheimersK01AG064040 · NIA · JOHNS HOPKINS UNIVERSITY · PI CHU, NADIA MIKHAIL · 2020 to 2022
$390k
NIAID NIH HHS K24 AI144954NIA NIH HHS K01 AG064040NIA NIH HHS P30 AG021334NIA NIH HHS R01 AG055781NIDDK NIH HHS K24 DK101828NIDDK NIH HHS R01 DK072367NIDDK NIH HHS R01 DK114074
6 · The paper itself

Abstract

backgroundFrailty, originally characterized in community-dwelling older adults, is increasingly being studied and implemented for adult patients with end-stage kidney disease (ESKD) of all ages (>18 years). Frailty prevalence and manifestation are unclear in younger adults (18-64 years) with ESKD; differences likely exist based on whether the patients are treated with hemodialysis (HD) or kidney transplantation (KT).

methodsWe leveraged 3 cohorts: 378 adults initiating HD (2008-2012), 4,304 adult KT candidates (2009-2019), and 1,396 KT recipients (2008-2019). The frailty phenotype was measured within 6 months of dialysis initiation, at KT evaluation, and KT admission. Prevalence of frailty and its components was estimated by age (≥65 vs. <65 years). A Wald test for interactions was used to test whether risk factors for frailty differed by age.

resultsIn all 3 cohorts, frailty prevalence was higher among older than younger adults (HD: 71.4 vs. 47.3%; candidates: 25.4 vs. 18.8%; recipients: 20.8 vs. 14.3%). In all cohorts, older patients were more likely to have slowness and weakness but less likely to report exhaustion. Among candidates, older age (odds ratio [OR] = 1.79, 95% CI: 1.47-2.17), non-Hispanic black race (OR = 1.30, 95% CI: 1.08-1.57), and dialysis type (HD vs. no dialysis: OR = 2.06, 95% CI: 1.61-2.64; peritoneal dialysis vs. no dialysis: OR = 1.78, 95% CI: 1.28-2.48) were associated with frailty prevalence, but sex and Hispanic ethnicity were not. These associations did not differ by age (pinteractions > 0.1). Similar results were observed for recipients and HD patients.

conclusionsAlthough frailty prevalence increases with age, younger patients have a high burden. Clinicians caring for this vulnerable population should recognize that younger patients may experience frailty and screen all age groups.

Indexed as

AdultAgedAge FactorsFemaleFrailtyHumansKidney Failure, ChronicKidney TransplantationMaleMiddle AgedPrevalenceProspective StudiesRenal DialysisRisk FactorsSelf ReportTime FactorsAgeDialysisEnd-stage kidney diseaseFrailtyKidney transplantation

Identifiers

PMID32640462
PMCPMC7442041

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.