BMC Nephrol. 2026 Jul 22;27(1):443. doi: 10.1186/s12882-026-05218-z.
ABSTRACT
BACKGROUND: There is still no established consensus on the optimal frailty screening tool for routine clinical application in patients with chronic kidney disease (CKD). We evaluated the accuracy of a visual analogue scale (VAS) for frailty screening and identified clinical predictors of frailty based on the modified Fried criteria.
METHODS: This cross-sectional, multicenter study included 122 adult patients on hemodialysis. Frailty status was assessed using modified Fried criteria and a 5-point self-rated VAS. The agreement between these two methods was evaluated using Cohen's Kappa. For the frailty prediction model we applied logistic regression with backwards selection among a set of clinical parameters associated with this condition. Pre-frail and robust individuals were analyzed as non-frail.
RESULTS: Median age was 68 years, 71% were male and 42.6% were considered frail according to Fried criteria. Cohen's Kappa was 0.36 (95% CI [0.21, 0.51]), indicating a fair level of agreement between VAS and Fried criteria. The VAS correctly identified most non-frail patients (specificity 94.3%, PPV 82.6%) while it missed a significant number of frail patients (sensitivity 36.5%, NPV 67.0%). Patients at risk for frailty based on the modified Fried criteria were more likely to have a central venous hemodialysis catheter, lower diuresis, lower creatinine and albumin, a higher prevalence of cardiovascular disease and use of analgesics. A model including these factors demonstrated good predictive performance with an AUC of 0.816 [95% CI 0.74, 0.90].
CONCLUSION: A self-rated VAS for frailty has the potential to simplify frailty screening and enhance its integration into routine nephrology care. A model based on routine parameters can support the identification of frail patients.
PMID:42493781 | DOI:10.1186/s12882-026-05218-z