Physical frailty and functional status in patients with advanced kidney disease: A protocol for a systematic review

Abstract

Background: Predicting outcomes in those with chronic kidney disease or following transplantation is challenging, and current models lack detailed patient-level information. Frailty and poor functional status are risk factors for adverse patient outcomes that may be useful additions to prognostic tools in patients with chronic kidney disease. The purpose of this systematic review is to examine whether frailty or functional status are associated with increased risk of mortality or adverse clinical outcomes in patients with advanced kidney disease. Methods/design: We will conduct a systematic review to identify and evaluate studies linking frailty and functional status with patient outcomes in populations with advanced kidney disease. We will search MEDLINE, Embase, and the Cochrane Central Register for Controlled Trials. Two reviewers will conduct all screening and data extraction independently. A modified version of the Quality In Prognosis Studies tool will be used to evaluate the quality of the studies. If meta-analysis of outcome data is possible, a random effects model will be used. Discussion: The results of this review will inform the development, selection, and validation of appropriate metrics needed to improve prognostication in patients with chronic kidney disease. Systematic review registration: PROSPERO CRD42016045251