Clinical Management of Chronic Kidney Disease in Frail Patients
A Special Issue of Clinics and Practice (ISSN 2039-7283) belonging to the section "Urology and Nephrology".
Deadline for manuscript submissions: 31 May 2027 | Viewed by 29
Editor
Interests: kidney disease; conservative kidney management; peritoneal dialysis; hemodialysis; acute kidney injury; regression modeling; statistical analysis
Special Issue Information
Dear Colleagues,
The global demographic shift toward an aging population has led to a marked rise in the prevalence of chronic kidney disease (CKD) among elderly and oldest-old individuals. Frailty, which is often comorbid with advanced CKD and end-stage kidney disease (ESKD), substantially affects clinical outcomes and treatment tolerance. Evidence-based recommendations for this population remain limited, as most pivotal trials have systematically excluded older, frail patients, leaving a critical evidence gap. Furthermore, observational data suggest that conservative kidney management (CKM) may confer survival and quality-of-life outcomes comparable to dialysis in selected frail patients, yet no definitive consensus on treatment superiority has been established.
Early identification of patients with stage G4 CKD is essential to facilitate multidisciplinary assessment, advance care planning, and allow informed decision-making, where CKM may represent an equally valid or preferable alternative to dialysis. Conversely, as underscored by KDIGO 2024 criteria, CKD diagnosis at earlier stages—particularly G3a—should not rely solely on GFR decline in the absence of additional kidney damage markers, to avoid overdiagnosis and its sequelae of unnecessary interventions and polypharmacy in older patients.
This Special Issue aims to consolidate current evidence on CKD management in frail and elderly patients, with a focus on individualized, patient-centered care.
Dr. Francesca K. Martino
Guest Editor
Manuscript Submission Information
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Keywords
- chronic kidney disease
- end-stage kidney disease
- frail elderly
- aging
- conservative kidney management
- renal replacement therapy
- survival
- quality of life
- shared decision-making
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