{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:06:07Z","timestamp":1790395567844,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T00:00:00Z","timestamp":1741392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There remains a lack of evidence based guidelines regarding the benefit of applying scoring systems in the outpatient nephrology setting. As such, we set out to investigate and follow\u2010up the utility of the Clinical Frailty Scale (CFS) for the ongoing management of patients with end stage kidney disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To explore the association between frailty, as measured by a Clinical Frailty Score (CFS) 5\u20138, and long\u2010term outcomes in a cohort of patients with chronic kidney disease (CKD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a 3\u2010year follow\u2010up analysis of a prospective cohort study. This study included participants of age &gt;50\u2009years and with CKD with an estimated glomerular filtration rate &lt;30 mL\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>. The primary outcome included actual end\u2010stage kidney disease (ESKD) management at 3\u2009years (transplantation, haemodialysis, peritoneal dialysis or supportive care). The secondary outcomes include all\u2010cause mortality, hospitalisation rates, and ESKD\u2010 and dialysis\u2010related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010nine of 81 patients from the initial study were included; two were lost to follow\u2010up. After 3\u2009years, 18 patients remained on conservative management, 20 on hospital haemodialysis and 13 on peritoneal dialysis. Non\u2010frail patients (CFS 1\u20134) were twice as likely to have ESKD treatment changes by 3\u2009years. This may carry clinical importance despite not achieving statistical significance (44% (<jats:italic>n<\/jats:italic> =\u200922) vs 22% (<jats:italic>n<\/jats:italic> =\u20094), <jats:italic>P<\/jats:italic> =\u20090.11). Hospitalisation rates were similar between groups (77.8% (<jats:italic>n<\/jats:italic> =\u200914) frail vs 82.0% (<jats:italic>n<\/jats:italic> =\u200941) non\u2010frail; <jats:italic>P<\/jats:italic> =\u20090.74). Mortality was higher in patients living with frailty at baseline (56% (<jats:italic>n<\/jats:italic> =\u200910) vs 8% (<jats:italic>n<\/jats:italic> =\u20094); <jats:italic>P<\/jats:italic> \u2264\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Of older adults screened for frailty, those not identified to be frail (CFS 1\u20134) were twice as likely to have changes in ESKD management as frail patients (CFS 5\u20138). Three\u2010year mortality was seven times higher (56%) in patients identified as frail at baseline. There were no statistically significant differences in hospitalisation rates or dialysis\u2010related or ESKD\u2010related complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.70009","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:58:23Z","timestamp":1741741103000},"page":"839-845","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Incorporating the Clinical Frailty Scale into routine outpatient nephrology practice: a 3\u2010year follow\u2010up of outcomes and associations"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6179-1056","authenticated-orcid":false,"given":"Nicholas","family":"Pizzino","sequence":"first","affiliation":[{"name":"Department of Geriatric Medicine Department of Nephrology Sir Charles Gairdner Hospital  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine Department of Nephrology Sir Charles Gairdner Hospital  Perth Western Australia Australia"},{"name":"Faculty of Health and Medical Sciences University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Soye","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine Department of Nephrology Sir Charles Gairdner Hospital  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Chakera","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine Department of Nephrology Sir Charles Gairdner Hospital  Perth Western Australia Australia"},{"name":"Faculty of Health and Medical Sciences University of Western Australia  Perth Western Australia Australia"},{"name":"Faculty of Health Sciences Curtin University  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuttara Panchali W.","family":"Kumarasinghe","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine Department of Nephrology Sir Charles Gairdner Hospital  Perth Western Australia Australia"},{"name":"Faculty of Health and Medical Sciences University of Western Australia  Perth Western Australia Australia"},{"name":"Faculty of Health Sciences Curtin University  Perth Western Australia 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