Dr Kirsten Hepburn1, Dr Louise Purtell1,2,4, Ms Laura Austin1, Ms Ilse Berquier1, Dr Katrina Kramer3, Professor Ann Bonner1,4, Associate Professor Helen Healy1
1Kidney Health Service, Royal Brisbane And Women’s Hospital, Herston, Australia, 2Research Development Unit, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Australia, 3Palliative and Supportive Care Service, Royal Brisbane and Women’s Hospital , Herston, Australia, 4School of Nursing and Midwifery, Griffith University, Southport, Australia
Background
Frailty is a multidimensional syndrome where physiological decline leads to increased vulnerability to adverse health outcomes. Frailty can be difficult to assess, but is common in people with CKD. The Clinical Frailty Scale (CFS), is a simple, albeit, subjective tool with significance as a predictor for mortality in CKD.
Aim
To examine frailty, using the CFS, in people attending a KSC clinic over a 10-month period.
Methods
Retrospective analysis of people attending KSC clinics between 1st July 2021 and 30th April 2022. Demographics, disease data, Charlson Comorbidity index (CCI), Resource Utilisation Group Activities Daily Living (RUG-ADL), Australia-modified Karnofsky Performance Status (AKPS), and treatment pathway, were extracted from clinical records. Medical and nursing staff rated frailty from 1 to 9 using the CFS. Results were analysed descriptively and group differences tested using the Mann-Whitney U test.
Results
The CFS was recorded for 240 people at 366 KSC attendances. Median age was 79.6 years (IQR 13.1 years), 43.8% were female, median eGFR was 16ml/min/1.73m2 (IQR 9ml/min/1.73m2) and 26% were on kidney replacement therapy (KRT). Average CCI was 6.9 (SD 2.0), median RUG-ADL 4 (IQR 1) and median AKPS 60 (IQR 10). Median CFS was 4 (IQR 2), representing very mild frailty. There was no significant difference in CFS between people on conservative and KRT pathways (p=0.11), with median CFS of 5 (IQR 2) and 4 (IQR 2) respectively.
Conclusion
Surprisingly, this study cohort were, in general, only rated as having very mild frailty using the CFS. Frailty was similar in people on conservative and KRT pathways. Selection bias may have contributed to these findings. Further longitudinal studies are required to understand frailty in the KSC population.
Biography:
Dr Kirsten Hepburn is an early career Nephrologist with a special interest in Kidney Supportive Care. She undertook a Clinical Diploma in Palliative Medicine in 2021 and is currently employed as the Kidney Supportive Care Nephrologist at the Royal Brisbane and Women’s Hospital.