Frailty and Advanced Chronic Kidney Disease

  • Research type

    Research Study

  • Full title

    The Association of Frailty with Advanced Chronic Kidney Disease: Haemodialysis Vs. Conservative Management

  • IRAS ID

    203472

  • Contact name

    Andrew Nixon

  • Contact email

    andrew.nixon@lthtr.nhs.uk

  • Sponsor organisation

    Lancashire Teaching Hospitals Trust

  • Duration of Study in the UK

    0 years, 8 months, 29 days

  • Research summary

    The Association of Frailty with Advanced Chronic Kidney Disease: Haemodialysis Vs. Conservative Management

    Frailty is a syndrome of reduced physical reserve that occurs as a consequence of progressive decline in multiple physiological systems. Frailty is common in elderly patients with chronic kidney disease (CKD) and is associated with impaired physical performance, disability, poorer quality of life and reduced survival.

    Counselling elderly patients on the standard treatment options of maintenance dialysis and maximal conservative therapy is challenging as it can be unclear which will offer the greatest benefit for the individual. We know that the commencement of dialysis does not appear to reduce frailty, but we don’t know if patients who are managed with maximal conservative management see a similar decline in their physical function and overall physiological reserve.

    We would argue that if dialysis mitigates progressive frailty, when compared with maximal conservative treatment, then nephrologists are more likely to recommend dialysis treatment. Likewise, if patients managed with dialysis have accelerated frailty when compared to those managed with maximal conservative treatment, conservative management may be a more beneficial management strategy, avoiding the significant treatment burden of dialysis.

    We hope to perform a longitudinal cohort study of patients’ ≥65 years of age with advanced CKD managed conservatively and with maintenance dialysis. We will assess frailty at baseline and 6 months post-recruitment in both groups. Participants will be recruited from the Renal Department at Lancashire Teaching Hospitals NHS Foundation Trust.

  • REC name

    North West - Greater Manchester Central Research Ethics Committee

  • REC reference

    16/NW/0453

  • Date of REC Opinion

    27 Jul 2016

  • REC opinion

    Further Information Favourable Opinion