Evidence map›Paper›PMID 39394084›Full record

SynthesisBMC medicine2024

Representation of multimorbidity and frailty in the development and validation of kidney failure prognostic prediction models: a systematic review.

Heather Walker, Scott Day, Christopher H Grant, Catrin Jones, Robert Ker, Michael K Sullivan, Bhautesh Dinesh Jani, Katie Gallacher, Patrick B Mark

Abstract readSystematic Review
In one paragraph

Synthesis in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. The kidney failure risk equation in people with CKD and multimorbidity: the effect of competing mortality risks.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Observational
  3. Body roundness index and mortality risk in patients with chronic kidney disease: moving beyond the obesity paradox.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Observational
  4. Article
  5. Article
  6. Frailty in Adults with CKD and Validation of the Kidney Failure Risk Equation in Frailty Subgroups.Clinical journal of the American Society of Nephrology : CJASN · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Heather WalkerSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland. heather.walker.2@glasgow.ac.uk.
Scott DayRenal Department, NHS Grampian, Aberdeen, Scotland.
Christopher H GrantPopulation Health and Genomics, School of Medicine, University of Dundee, Dundee, Scotland.
Catrin JonesGeneral Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Robert KerRenal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, Scotland.
Michael K SullivanSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland.
Bhautesh Dinesh JaniGeneral Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Katie GallacherGeneral Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.
Patrick B MarkSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, Scotland.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundPrognostic models that identify individuals with chronic kidney disease (CKD) at greatest risk of developing kidney failure help clinicians to make decisions and deliver precision medicine. It is recognised that people with CKD usually have multiple long-term health conditions (multimorbidity) and often experience frailty. We undertook a systematic review to evaluate the representation and consideration of multimorbidity and frailty within CKD cohorts used to develop and/or validate prognostic models assessing the risk of kidney failure.

methodsWe identified studies that described derivation, validation or update of kidney failure prognostic models in MEDLINE, CINAHL Plus and the Cochrane Library-CENTRAL. The primary outcome was representation of multimorbidity or frailty. The secondary outcome was predictive accuracy of identified models in relation to presence of multimorbidity or frailty.

resultsNinety-seven studies reporting 121 different kidney failure prognostic models were identified. Two studies reported prevalence of multimorbidity and a single study reported prevalence of frailty. The rates of specific comorbidities were reported in a greater proportion of studies: 67.0% reported baseline data on diabetes, 54.6% reported hypertension and 39.2% reported cardiovascular disease. No studies included frailty in model development, and only one study considered multimorbidity as a predictor variable. No studies assessed model performance in populations in relation to multimorbidity. A single study assessed associations between frailty and the risks of kidney failure and death.

conclusionsThere is a paucity of kidney failure risk prediction models that consider the impact of multimorbidity and/or frailty, resulting in a lack of clear evidence-based practice for multimorbid or frail individuals. These knowledge gaps should be explored to help clinicians know whether these models can be used for CKD patients who experience multimorbidity and/or frailty. SYSTEMATIC REVIEW REGISTRATION: This review has been registered on PROSPERO (CRD42022347295).

Indexed as

FrailtyMultimorbidityRenal InsufficiencyHumansPrognosisRenal Insufficiency, ChronicChronic renal failureCKDFrailtyGuidelinesMultimorbidityPrognosisSystematic review

Identifiers

PMID39394084
PMCPMC11470573

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.