ArticleCanadian journal of kidney health and disease2021
Frailty Severity and Hospitalization After Dialysis Initiation.
Article in Canadian journal of kidney health and disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Association Between Frailty and Mortality, Falls and Hospitalisation Among Patients Undergoing Dialysis: A Systematic Review and Meta-Analysis.Nursing open · 2025Pooled it
- Recommendations for the management of frailty in chronic kidney disease: a consensus report.Nature reviews. Nephrology · 2026Review
- Outcomes for Frail Dialysis Patients Not Referred for Transplantation: A Cohort Study.Journal of the American Geriatrics Society · 2026Article
- Bibliometric analysis of frailty in dialysis patients: knowledge mapping and trends.International urology and nephrology · 2026Review
- Kidney Transplant Referral, Activation, and Transplantation Rates in a Single-Center Cohort of Older Adults in Nova Scotia.Clinical transplantation · 2026Article
- Frailty in Focus: A Scoping Review of Frailty Instruments from the Kidney Disease Aging Research Collaborative.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Frailty Assessment Tools in Chronic Kidney Disease: A Systematic Review and Meta-analysis.Kidney medicine · 2025Article
- 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 · 2025Review
- Impact of arteriovenous fistula formation on trajectory of kidney function decline: a target trial emulation.Clinical kidney journal · 2024Article
- Observational
- Frailty in hemodialysis patients: results of a screening program and multidisciplinary interventions.Clinical kidney journal · 2023Article
- Use of frailty assessment instruments in nephrology populations: a scoping review.BMC geriatrics · 2023Article
- Clinical frailty assessment might be associated with mortality in incident dialysis patients.Scientific reports · 2022Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFrailty is associated with hospitalization and mortality among dialysis patients. To now, few studies have considered the degree of frailty as a predictor of hospitalization.
objectiveWe evaluated whether
designRetrolective cohort study.
settingNova Scotia, Canada. PATIENTS: Consecutive adult, chronic dialysis patients who initiated dialysis from January 1, 2009 to June 30, 2014, (last follow-up June, 2015).
methodsFrailty Severity, as determined by the 7-point Clinical Frailty Scale (CFS, ranging from 1 = very fit to 7 = severely frail), was measured at dialysis initiation and treated as continuous and in categories (CFS scores of 1-3, 4/5, and 6/7). Hospitalization was characterized by cumulative time admitted to hospital (proportion of days admitted/time at risk) and by the joint risk of hospitalization and death. Time at risk included time in hospital after dialysis initiation and patients were followed until transplantation or death.
resultsOf 647 patients (mean age: 62 ± 15), 564 (87%) had CFS scores. The mean CFS score was 4 ("corresponding to "vulnerable") ± 2 ("well" to "moderately frail"). In an adjusted negative binomial regression model, moderate-severely frail patients (CFS 6/7) had a >2-fold increased risk of cumulative time admitted to hospital compared to the lowest CFS category (IRR = 2.18, 95% confidence interval [CI] = 1.31-3.63). In the joint model, moderate-severely frail patients had a 61% increase in the relative hazard for hospitalization (hazard ratio [HR] = 1.61, 95% CI = 1.29-2.02) and a 93% increase in the relative hazard for death compared to the lowest CFS category (HR = 1.93, 95% CI = 1.16-3.22). LIMITATIONS: Potential unknown confounders may have affected the association between frailty severity and hospitalization given observational study design. The CFS is subjective and different clinicians may grade frailty severity differently or misclassify patients on the basis of limited availability.
conclusionsAmong incident dialysis patients, a higher frailty severity as defined by the CFS is associated with both an increased risk of cumulative time admitted to hospital and joint risk of hospitalization and death.
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