{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T14:57:59Z","timestamp":1768402679199,"version":"3.49.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Harry Summers Endowment Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Over the last 30\u00a0years, with increasing comorbidity and frailty among people with end-stage kidney disease, there is recognition that dialysis may carry little benefit in some patient groups. We examined the utility of the electronic frailty index (eFI), modelling the survival time of patients starting dialysis at a single renal unit in northern England, hypothesising this would give useful prognostic survival information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two datasets describing the same population of patients receiving dialysis over a 226-month period (2000\u20132019) at a single dialysis unit were used (n\u00a0=\u00a0599 and 553 participants). One dataset was derived from primary care (linked to UK Renal Registry submissions) and the other from the UK Renal Registry (linked with primary care data to facilitate eFI calculation). Retrospective survival analysis was undertaken with hazard ratios for the impact of eFI and other covariates on survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The frailty score at dialysis start has a strong effect on subsequent survival time using either the primary care\u2013derived or UK Renal Registry dataset, but there were differences in overall survival and the relation between eFI score and survival between datasets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This represents the first study of eFI utility within tertiary renal care, demonstrating a strong association between frailty measured by eFI and survival time for patients on dialysis. However, significant differences between primary care\u2013derived and UK Renal Registry\u2013derived survival at different frailty scores were demonstrated. These differences indicate a need for greater understanding and analysis of large datasets before using them to discuss patient treatment choices, service planning and delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf355","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T13:04:26Z","timestamp":1763816666000},"source":"Crossref","is-referenced-by-count":0,"title":["The electronic frailty index indicates mortality risk in end stage kidney disease patients on haemodialysis: retrospective survival analyses using linked data from two sources"],"prefix":"10.1093","volume":"19","author":[{"given":"Samuel D","family":"Relton","sequence":"first","affiliation":[{"name":"Leeds Institute of Health Sciences, School of Medicine, University of Leeds , Leeds ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Hewison","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences, School of Medicine, University of Leeds , Leeds ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Rogers","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences, School of Medicine, University of Leeds , Leeds ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usha","family":"Appalsawmy","sequence":"additional","affiliation":[{"name":"Renal Unit, Leeds Teaching Hospitals NHS Trust , Leeds ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuldeep","family":"Sohal","sequence":"additional","affiliation":[{"name":"Bradford Institute for Health Research , Bradford ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Birkinshaw","sequence":"additional","affiliation":[{"name":"Bradford Institute for Health Research , Bradford ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Stoves","sequence":"additional","affiliation":[{"name":"Renal Unit, Bradford Royal Infirmary , Bradford ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"West","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences, School of Medicine, University of Leeds , Leeds ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Mooney","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences, School of Medicine, University of Leeds , Leeds ,","place":["UK"]},{"name":"Renal Unit, Leeds Teaching Hospitals NHS Trust , Leeds ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,22]]},"reference":[{"key":"2026011404270119900_bib1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1159\/000504851","article-title":"The 21st UK Renal Registry annual report: a summary of analyses of adult data in 2017","volume":"144","author":"Pyart","year":"2020","journal-title":"Nephron"},{"key":"2026011404270119900_bib2","doi-asserted-by":"publisher","first-page":"iii604","DOI":"10.1093\/ndt\/gfv200.01","article-title":"SP682 A cost and outcomes analysis of renal replacement therapies using real-world quality of life data","volume":"30","author":"Nagaraja","year":"2015","journal-title":"Nephrol Dial Transplant"},{"key":"2026011404270119900_bib3","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1053\/j.ackd.2006.10.001","article-title":"The prevalence of symptoms in end-stage renal disease: a systematic review","volume":"14","author":"Murtagh","year":"2007","journal-title":"Adv Chronic Kidney Dis"},{"key":"2026011404270119900_bib4","doi-asserted-by":"publisher","first-page":"633","DOI":"10.2215\/CJN.07510715","article-title":"Comparative survival among older adults with advanced kidney disease managed conservatively versus with dialysis","volume":"11","author":"Verberne","year":"2016","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026011404270119900_bib5","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1136\/bmj.318.7178.217","article-title":"Is there a rationale for rationing chronic dialysis? 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