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.