Baseline Characteristics of Frailty and Disease Stage in Older People Living With CKD

Benignus Logan; Elaine M. Pascoe; Andrea K. Viecelli; David W. Johnson; Tracy Comans; Carmel M. Hawley; Laura E. Hickey; Monika Janda; Allison Jaure; Emarene Kalaw; Charani Kiriwandeniya; Misa Matsuyama; Gabor Mihala; Kim Huong Nguyen; Jason D. Pole; Kevan R. Polkinghorne; Dimity Pond; Rajesh Raj; Donna M. Reidlinger; Nicole Scholes-Robertson; Andrea Valks; Germaine Wong; Ruth E. Hubbard; on behalf of The GOAL Trial Investigators

doi:10.1016/j.ekir.2024.10.009

Baseline Characteristics of Frailty and Disease Stage in Older People Living With CKD

Benignus Logan, Elaine M. Pascoe, Andrea K. Viecelli, David W. Johnson, Tracy Comans, Carmel M. Hawley, Laura E. Hickey, Monika Janda, Allison Jaure, Emarene Kalaw, Charani Kiriwandeniya, Misa Matsuyama, Gabor Mihala, Kim Huong Nguyen, Jason D. Pole, Kevan R. Polkinghorne, Dimity Pond, Rajesh Raj, Donna M. Reidlinger, Nicole Scholes-RobertsonAndrea Valks, Germaine Wong, Ruth E. Hubbard, on behalf of The GOAL Trial Investigators

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Abstract

Introduction: The GOAL trial, a cluster randomized controlled trial, investigated the effect of comprehensive geriatric assessment (CGA) on frail older people with chronic kidney disease (CKD). This paper describes the following: (i) participant baseline characteristics, and (ii) their relationship with CKD stage and frailty severity.

Methods: Sixteen kidney outpatient clinics (clusters) were randomly allocated 1:1 to CGA or usual care. Enrolled frail older people with CKD (Frailty Index [FI] > 0.25; aged ≥65 years or ≥55 if First Nations people) received the intervention allocated to their cluster. CKD was defined as moderate (stages 3 or 4) or severe (stage 5 or 5D), and frailty categorized as moderate (>0.25–<0.36), severe (0.36–<0.45) or very severe (≥0.45). Participant characteristics were analyzed using descriptive statistics. Statistical methods appropriate for type of outcome were used to describe the association of frailty and CKD categories with participant characteristics.

Results: Over a 27-month period, 240 people were recruited (55.7% male, 82.9% White/European). Mean age was 76.9 (SD: 6.6) years and median FI was 0.39 (interquartile range [IQR]: 0.32–0.47). The median EQ-5D-5L quality-of-life index score was worse in those with very severe frailty (0.57, IQR: 0.28–0.83) compared to severe frailty (0.85, IQR: 0.67–0.92) and moderate frailty (0.90, IQR: 0.82–0.93) (overall P < 0.001). Median EQ-5D-5L was also worse in those with severe CKD (0.79, IQR: 0.40–0.89), compared to moderate CKD (median 0.87, IQR: 0.73–0.92; P = 0.001).

Conclusion: This cohort demonstrated poorer quality-of-life scores in those with more severe frailty and more advanced CKD.

Original language	English
Pages (from-to)	120-133
Number of pages	14
Journal	Kidney International Reports
Volume	10
Issue number	1
DOIs	https://doi.org/10.1016/j.ekir.2024.10.009
Publication status	Published - Jan 2025
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2024 International Society of Nephrology

Keywords

chronic kidney disease
comprehensive geriatric assessment
frailty
goal attainment scaling
older people
quality of life

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Logan, B., Pascoe, E. M., Viecelli, A. K., Johnson, D. W., Comans, T., Hawley, C. M., Hickey, L. E., Janda, M., Jaure, A., Kalaw, E., Kiriwandeniya, C., Matsuyama, M., Mihala, G., Nguyen, K. H., Pole, J. D., Polkinghorne, K. R., Pond, D., Raj, R., Reidlinger, D. M., ... on behalf of The GOAL Trial Investigators (2025). Baseline Characteristics of Frailty and Disease Stage in Older People Living With CKD. Kidney International Reports, 10(1), 120-133. https://doi.org/10.1016/j.ekir.2024.10.009

@article{479cc61e5af04bfb8845bbb703d95227,

title = "Baseline Characteristics of Frailty and Disease Stage in Older People Living With CKD",

abstract = "Introduction: The GOAL trial, a cluster randomized controlled trial, investigated the effect of comprehensive geriatric assessment (CGA) on frail older people with chronic kidney disease (CKD). This paper describes the following: (i) participant baseline characteristics, and (ii) their relationship with CKD stage and frailty severity.Methods: Sixteen kidney outpatient clinics (clusters) were randomly allocated 1:1 to CGA or usual care. Enrolled frail older people with CKD (Frailty Index [FI] > 0.25; aged ≥65 years or ≥55 if First Nations people) received the intervention allocated to their cluster. CKD was defined as moderate (stages 3 or 4) or severe (stage 5 or 5D), and frailty categorized as moderate (>0.25–<0.36), severe (0.36–<0.45) or very severe (≥0.45). Participant characteristics were analyzed using descriptive statistics. Statistical methods appropriate for type of outcome were used to describe the association of frailty and CKD categories with participant characteristics.Results: Over a 27-month period, 240 people were recruited (55.7% male, 82.9% White/European). Mean age was 76.9 (SD: 6.6) years and median FI was 0.39 (interquartile range [IQR]: 0.32–0.47). The median EQ-5D-5L quality-of-life index score was worse in those with very severe frailty (0.57, IQR: 0.28–0.83) compared to severe frailty (0.85, IQR: 0.67–0.92) and moderate frailty (0.90, IQR: 0.82–0.93) (overall P < 0.001). Median EQ-5D-5L was also worse in those with severe CKD (0.79, IQR: 0.40–0.89), compared to moderate CKD (median 0.87, IQR: 0.73–0.92; P = 0.001).Conclusion: This cohort demonstrated poorer quality-of-life scores in those with more severe frailty and more advanced CKD.",

keywords = "chronic kidney disease, comprehensive geriatric assessment, frailty, goal attainment scaling, older people, quality of life",

author = "Benignus Logan and Pascoe, {Elaine M.} and Viecelli, {Andrea K.} and Johnson, {David W.} and Tracy Comans and Hawley, {Carmel M.} and Hickey, {Laura E.} and Monika Janda and Allison Jaure and Emarene Kalaw and Charani Kiriwandeniya and Misa Matsuyama and Gabor Mihala and Nguyen, {Kim Huong} and Pole, {Jason D.} and Polkinghorne, {Kevan R.} and Dimity Pond and Rajesh Raj and Reidlinger, {Donna M.} and Nicole Scholes-Robertson and Andrea Valks and Germaine Wong and Hubbard, {Ruth E.} and {on behalf of The GOAL Trial Investigators} and Antony, {Deanna Nisha} and Ricky Arenson and Owen Bale and Sabine Braat and {Lobo Brites}, {Benilda Maria} and Sally Broers and Graham Buckle and Sreenath Bukkapatnam and Joanne Cerni and Doris Chan and Collins, {Michael G.} and Amanda Elms and John Fanning and Karen Fischer and Adam Flavell and Leon Flicker and Chloe Furst and Gordon, {Emily H.} and Sridevi Govindarajulu and Natalie Grainer and Green, {Stella Jean} and Green, {Suetonia C.} and Chandana Guha and Samantha Hand and {Nur Hidayati}, {Leny Dwi} and Rachael Irvine and Ibrahim Ismail and Shilpanjali Jesudason and George Kan and Kang, {Ya Yu} and Leonie Kelly and Debbie Kennedy and Khadija Khatry and Vinod Khelgi and Shannon Kokoszka and Anoushka Krishnan and Heather Lane and Diana Leary and Andrea Lees and Claire Long and Angela Makris and Marquez, {Khalilah Katherine} and Amanda Maxwell and Amanda McGrath and David McIntyre and Penelope Murie and Karina Murphy and Chr{\'o}in{\'i}n, {Danielle N{\'i}} and Peel, {Nancye M.} and Stephanie Polley and Xiaodan Qiu and Madeleine Rapisardi and Roberts, {Matthew A.} and Roger, {Simon D.} and Shailly Saxena and Shaundeep Sen and Edward Strivens and Julie Varghese and Waite, {Louise M.} and Robert Walker and Daniel Wong and Yates, {Paul Andrew} and Belinda Yip and Andreea Zaharia",

note = "Publisher Copyright: {\textcopyright} 2024 International Society of Nephrology",

year = "2025",

month = jan,

doi = "10.1016/j.ekir.2024.10.009",

language = "English",

volume = "10",

pages = "120--133",

journal = "Kidney International Reports",

issn = "2468-0249",

publisher = "Elsevier Inc.",

number = "1",

}

Logan, B, Pascoe, EM, Viecelli, AK, Johnson, DW, Comans, T, Hawley, CM, Hickey, LE, Janda, M, Jaure, A, Kalaw, E, Kiriwandeniya, C, Matsuyama, M, Mihala, G, Nguyen, KH, Pole, JD, Polkinghorne, KR, Pond, D, Raj, R, Reidlinger, DM, Scholes-Robertson, N, Valks, A, Wong, G, Hubbard, RE & on behalf of The GOAL Trial Investigators 2025, 'Baseline Characteristics of Frailty and Disease Stage in Older People Living With CKD', Kidney International Reports, vol. 10, no. 1, pp. 120-133. https://doi.org/10.1016/j.ekir.2024.10.009

TY - JOUR

T1 - Baseline Characteristics of Frailty and Disease Stage in Older People Living With CKD

AU - Logan, Benignus

AU - Pascoe, Elaine M.

AU - Viecelli, Andrea K.

AU - Johnson, David W.

AU - Comans, Tracy

AU - Hawley, Carmel M.

AU - Hickey, Laura E.

AU - Janda, Monika

AU - Jaure, Allison

AU - Kalaw, Emarene

AU - Kiriwandeniya, Charani

AU - Matsuyama, Misa

AU - Mihala, Gabor

AU - Nguyen, Kim Huong

AU - Pole, Jason D.

AU - Polkinghorne, Kevan R.

AU - Pond, Dimity

AU - Raj, Rajesh

AU - Reidlinger, Donna M.

AU - Scholes-Robertson, Nicole

AU - Valks, Andrea

AU - Wong, Germaine

AU - Hubbard, Ruth E.

AU - on behalf of The GOAL Trial Investigators

AU - Antony, Deanna Nisha

AU - Arenson, Ricky

AU - Bale, Owen

AU - Braat, Sabine

AU - Lobo Brites, Benilda Maria

AU - Broers, Sally

AU - Buckle, Graham

AU - Bukkapatnam, Sreenath

AU - Cerni, Joanne

AU - Chan, Doris

AU - Collins, Michael G.

AU - Elms, Amanda

AU - Fanning, John

AU - Fischer, Karen

AU - Flavell, Adam

AU - Flicker, Leon

AU - Furst, Chloe

AU - Gordon, Emily H.

AU - Govindarajulu, Sridevi

AU - Grainer, Natalie

AU - Green, Stella Jean

AU - Green, Suetonia C.

AU - Guha, Chandana

AU - Hand, Samantha

AU - Nur Hidayati, Leny Dwi

AU - Irvine, Rachael

AU - Ismail, Ibrahim

AU - Jesudason, Shilpanjali

AU - Kan, George

AU - Kang, Ya Yu

AU - Kelly, Leonie

AU - Kennedy, Debbie

AU - Khatry, Khadija

AU - Khelgi, Vinod

AU - Kokoszka, Shannon

AU - Krishnan, Anoushka

AU - Lane, Heather

AU - Leary, Diana

AU - Lees, Andrea

AU - Long, Claire

AU - Makris, Angela

AU - Marquez, Khalilah Katherine

AU - Maxwell, Amanda

AU - McGrath, Amanda

AU - McIntyre, David

AU - Murie, Penelope

AU - Murphy, Karina

AU - Chróinín, Danielle Ní

AU - Peel, Nancye M.

AU - Polley, Stephanie

AU - Qiu, Xiaodan

AU - Rapisardi, Madeleine

AU - Roberts, Matthew A.

AU - Roger, Simon D.

AU - Saxena, Shailly

AU - Sen, Shaundeep

AU - Strivens, Edward

AU - Varghese, Julie

AU - Waite, Louise M.

AU - Walker, Robert

AU - Wong, Daniel

AU - Yates, Paul Andrew

AU - Yip, Belinda

AU - Zaharia, Andreea

PY - 2025/1

Y1 - 2025/1

N2 - Introduction: The GOAL trial, a cluster randomized controlled trial, investigated the effect of comprehensive geriatric assessment (CGA) on frail older people with chronic kidney disease (CKD). This paper describes the following: (i) participant baseline characteristics, and (ii) their relationship with CKD stage and frailty severity.Methods: Sixteen kidney outpatient clinics (clusters) were randomly allocated 1:1 to CGA or usual care. Enrolled frail older people with CKD (Frailty Index [FI] > 0.25; aged ≥65 years or ≥55 if First Nations people) received the intervention allocated to their cluster. CKD was defined as moderate (stages 3 or 4) or severe (stage 5 or 5D), and frailty categorized as moderate (>0.25–<0.36), severe (0.36–<0.45) or very severe (≥0.45). Participant characteristics were analyzed using descriptive statistics. Statistical methods appropriate for type of outcome were used to describe the association of frailty and CKD categories with participant characteristics.Results: Over a 27-month period, 240 people were recruited (55.7% male, 82.9% White/European). Mean age was 76.9 (SD: 6.6) years and median FI was 0.39 (interquartile range [IQR]: 0.32–0.47). The median EQ-5D-5L quality-of-life index score was worse in those with very severe frailty (0.57, IQR: 0.28–0.83) compared to severe frailty (0.85, IQR: 0.67–0.92) and moderate frailty (0.90, IQR: 0.82–0.93) (overall P < 0.001). Median EQ-5D-5L was also worse in those with severe CKD (0.79, IQR: 0.40–0.89), compared to moderate CKD (median 0.87, IQR: 0.73–0.92; P = 0.001).Conclusion: This cohort demonstrated poorer quality-of-life scores in those with more severe frailty and more advanced CKD.

AB - Introduction: The GOAL trial, a cluster randomized controlled trial, investigated the effect of comprehensive geriatric assessment (CGA) on frail older people with chronic kidney disease (CKD). This paper describes the following: (i) participant baseline characteristics, and (ii) their relationship with CKD stage and frailty severity.Methods: Sixteen kidney outpatient clinics (clusters) were randomly allocated 1:1 to CGA or usual care. Enrolled frail older people with CKD (Frailty Index [FI] > 0.25; aged ≥65 years or ≥55 if First Nations people) received the intervention allocated to their cluster. CKD was defined as moderate (stages 3 or 4) or severe (stage 5 or 5D), and frailty categorized as moderate (>0.25–<0.36), severe (0.36–<0.45) or very severe (≥0.45). Participant characteristics were analyzed using descriptive statistics. Statistical methods appropriate for type of outcome were used to describe the association of frailty and CKD categories with participant characteristics.Results: Over a 27-month period, 240 people were recruited (55.7% male, 82.9% White/European). Mean age was 76.9 (SD: 6.6) years and median FI was 0.39 (interquartile range [IQR]: 0.32–0.47). The median EQ-5D-5L quality-of-life index score was worse in those with very severe frailty (0.57, IQR: 0.28–0.83) compared to severe frailty (0.85, IQR: 0.67–0.92) and moderate frailty (0.90, IQR: 0.82–0.93) (overall P < 0.001). Median EQ-5D-5L was also worse in those with severe CKD (0.79, IQR: 0.40–0.89), compared to moderate CKD (median 0.87, IQR: 0.73–0.92; P = 0.001).Conclusion: This cohort demonstrated poorer quality-of-life scores in those with more severe frailty and more advanced CKD.

KW - chronic kidney disease

KW - comprehensive geriatric assessment

KW - frailty

KW - goal attainment scaling

KW - older people

KW - quality of life

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UR - http://purl.org/au-research/grants/NHMRC/APP1178519

UR - http://purl.org/au-research/grants/NHMRC/1196033

UR - http://purl.org/au-research/grants/NHMRC/APP1194485

U2 - 10.1016/j.ekir.2024.10.009

DO - 10.1016/j.ekir.2024.10.009

M3 - Article

AN - SCOPUS:85208589589

SN - 2468-0249

VL - 10

SP - 120

EP - 133

JO - Kidney International Reports

JF - Kidney International Reports

IS - 1

ER -

Baseline Characteristics of Frailty and Disease Stage in Older People Living With CKD

Abstract

Bibliographical note

Keywords

UN SDGs

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