{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:05:58Z","timestamp":1790395558397,"version":"4.1.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","funder":[{"DOI":"10.13039\/100010875","name":"Amgen Canada","doi-asserted-by":"crossref","award":["NAP"],"award-info":[{"award-number":["NAP"]}],"id":[{"id":"10.13039\/100010875","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n The term, frailty, had unclear meaning for most participants but was commonly explained as weakness, dependence, and unmodifiable.<\/jats:p>\n <\/jats:list-item>\n \n Knowledge of frailty assessment tools and the evidence to support their prognostic utility was low among clinicians.<\/jats:p>\n <\/jats:list-item>\n \n Though patients and caregivers saw value in discussing frailty, the label of frailty was often viewed as pejorative.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Frailty is highly prevalent among individuals with kidney failure and independently associated with poor health outcomes. Identifying and managing frailty can inform prognosis and care but stakeholders' understanding of frailty and their perspectives on how to detect and manage it in routine kidney care are unknown.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We recruited participants from four Canadian kidney programs in Alberta, Manitoba, and Nova Scotia from January 2021 to June 2023. We conducted focus groups and semistructured interviews with patients (50 years or older with dialysis-dependent or nondependent kidney failure), caregivers, allied health care professionals, and nephrologists. We used qualitative description and inductive thematic analysis to describe their perspectives.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ninety-one people participated: patients (\n N<\/jats:italic>\n =31), caregivers (\n N<\/jats:italic>\n =8), kidney allied health care professionals (\n N<\/jats:italic>\n =38), and nephrologists (\n N<\/jats:italic>\n =14). We identified three themes, each with subthemes: (\n 1<\/jats:italic>\n ) What is frailty? All groups expressed uncertainty, but frailty was commonly described as physical, visible, inevitable, and fixed; (\n 2<\/jats:italic>\n ) discussing frailty: the value of knowing what to expect with frailty, and frailty as a difficult topic to discuss; (\n 3<\/jats:italic>\n ) frailty assessment and management: skepticism from patients and caregivers that frailty is measurable; support from clinicians for a systematic approach to identifying frailty but a lack of knowledge on multidisciplinary roles and potential interventions. For all groups, having\n actionable solutions<\/jats:italic>\n after identifying frailty was key for acceptability and successful implementation.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Education on the nature and potentially modifiable aspects of frailty as well as the scope and potential benefits of frailty interventions is necessary for successful implementation of frailty detection and management in kidney care.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.0000000796","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T16:08:26Z","timestamp":1754064506000},"page":"1407-1417","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["A Qualitative Study Describing the Perspectives on Frailty and Its Management in Individuals with Kidney Failure"],"prefix":"10.2215","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3109-6837","authenticated-orcid":false,"given":"Stephanie","family":"Thompson","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5319-5522","authenticated-orcid":false,"given":"Joanna","family":"Czupryn","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4054-9861","authenticated-orcid":false,"given":"Rachelle","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7710-7162","authenticated-orcid":false,"given":"Clara","family":"Bohm","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Max Rady College of Medicine, and Chronic Disease Innovation Centre at Seven Oaks General Hospital, University of Manitoba, Winnipeg, Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0846-3187","authenticated-orcid":false,"given":"Marcello","family":"Tonelli","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-1440","authenticated-orcid":false,"given":"Jennifer M.","family":"MacRae","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7919-6709","authenticated-orcid":false,"given":"Karthik","family":"Tennankore","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0527-7538","authenticated-orcid":false,"given":"Carmel L.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4513-6449","authenticated-orcid":false,"given":"Sara N.","family":"Davison","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"issue":"12","key":"B1-20260520","doi-asserted-by":"crossref","first-page":"1163.e1","DOI":"10.1016\/j.jamda.2016.09.010","article-title":"Frailty and the prediction of negative health outcomes: a meta-analysis","volume":"17","author":"Vermeiren","year":"2016","journal-title":"J Am Med Dir Assoc."},{"issue":"10206","key":"B2-20260520","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31786-6","article-title":"Frailty: implications for clinical practice and public health","volume":"394","author":"Hoogendijk","year":"2019","journal-title":"Lancet."},{"issue":"9","key":"B3-20260520","doi-asserted-by":"crossref","first-page":"2270","DOI":"10.1016\/j.ekir.2021.05.025","article-title":"Frailty in CKD and transplantation","volume":"6","author":"Lorenz","year":"2021","journal-title":"Kidney Int Rep."},{"issue":"7","key":"B4-20260520","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1159\/000508576","article-title":"Frailty prevalence in younger end-stage kidney disease patients undergoing dialysis and transplantation","volume":"51","author":"Chu","year":"2020","journal-title":"Am J Nephrol."},{"issue":"2","key":"B5-20260520","doi-asserted-by":"crossref","first-page":"2300442","DOI":"10.1183\/13993003.00442-2023","article-title":"European respiratory society statement on frailty in adults with chronic lung disease","volume":"62","author":"Osadnik","year":"2023","journal-title":"Eur Respir J."},{"issue":"11","key":"B6-20260520","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1002\/ejhf.1611","article-title":"Heart Failure Association\/European Society of Cardiology position paper on frailty in patients with heart failure","volume":"21","author":"Vitale","year":"2019","journal-title":"Eur J Heart 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