Table 2.

Healthy, vulnerable, and frail renal phenotypes with assessment tools

Renal phenotypes

Healthy/usual

Most optimal dialysis patient

Might also be a transplant candidate

Vulnerable

More typical dialysis candidate

Characterized by increasing hospitalizations and unpredictable outcomes

Frail

Most susceptible to poor near-term outcome (6–12 months)

High risk of multiple and prolonged hospitalizations

Some are nursing home patients with marked functional disability, cognitive impairment, and dementia

Medical care decisions depend more on patient preferences and quality of life issues

Assessment tools

Geriatric susceptibility factors

Presence of dementia

Presence of frailty

Functional disability

Comorbidity

Modified Charleson comorbidity score (36)

Hemodialysis mortality predictor (35)

French Renal Epidemiology and Information Network 6-Month Prognosis Clinical Score (37)

Surprise question (38)

Nursing home patient syndrome (6)

Symptom burden assessment (13)

Modified from reference 34, with permission.