{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T21:43:45Z","timestamp":1768340625128,"version":"3.49.0"},"reference-count":47,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2021,9,11]],"date-time":"2021-09-11T00:00:00Z","timestamp":1631318400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Patients under dialysis are known to be more vulnerable to frailty, a dynamic geriatric syndrome defined as a state of vulnerability to stressors, due to numerous metabolic changes. With rise of life expectancy globally, it is important to understand the complexity of the pathophysiology of frailty and identify possible markers that can help with the prognosis and diagnosis of frailty. The aim of this systematic review is to give an overview of the knowledge regarding clinical and biochemical markers associated with pre-frailty and frailty in dialysis and pre-dialysis patients. In November 2020, PubMed, Embase and Web of Science were searched. Studies regarding biomarkers associated with (pre-)frailty in (pre-)dialysis patients were included. This systematic review identified clinical and biochemical markers in pre-frail and frail patients under dialysis or pre-dialysis published in the literature. This study shows that more investigation is necessary to identify markers that can differentiate these processes to be used as a diagnostic and prognostic tool in routine care and management of geriatric needs. Interventions that can improve health outcomes in pre-frail and frail older adults under dialysis or pre-dialysis are essential to improve not only the individual\u2019s quality of life but also to reduce the burden to the health systems.<\/jats:p>","DOI":"10.3390\/ijerph18189579","type":"journal-article","created":{"date-parts":[[2021,9,12]],"date-time":"2021-09-12T21:45:57Z","timestamp":1631483157000},"page":"9579","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Pre-Frailty and Frailty in Dialysis and Pre-Dialysis Patients: A Systematic Review of Clinical and Biochemical Markers"],"prefix":"10.3390","volume":"18","author":[{"given":"Ana","family":"Pereira","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1981-2554","authenticated-orcid":false,"given":"Lu\u00eds","family":"Mid\u00e3o","sequence":"additional","affiliation":[{"name":"UCIBIO REQUIMTE, Faculty of Pharmacy, Porto4Ageing, University of Porto, 4050-313 Porto, Portugal"},{"name":"School of Medicine and Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal"}]},{"given":"Marta","family":"Almada","sequence":"additional","affiliation":[{"name":"UCIBIO REQUIMTE, Faculty of Pharmacy, Porto4Ageing, University of Porto, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1158-1480","authenticated-orcid":false,"given":"El\u00edsio","family":"Costa","sequence":"additional","affiliation":[{"name":"UCIBIO REQUIMTE, Faculty of Pharmacy, Porto4Ageing, University of Porto, 4050-313 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12882-015-0150-1","article-title":"Association of Frailty With Endothelial Dysfunction and Its Possible Impact on Negative Outcomes in Brazilian Predialysis Patients With Chronic Kidney Disease","volume":"16","author":"Mansur","year":"2015","journal-title":"BMC Nephrol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.14283\/jfa.2020.44","article-title":"Prevalence of Falls and Associated Factors Among Community-Dwelling Older Adults: A Cross-Sectional Study","volume":"10","author":"Almada","year":"2020","journal-title":"J. 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