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Peer-reviewedCC BYGeriatrics (Basel, Switzerland)

Frailty-Informed Assessment in Peritoneal Dialysis: A Multicenter Survey of Current Practice and Implementation Barriers in Spain.

9 more authors
20 affiliations
  1. 1Nephrology Department, Instituto de Investigación Puerta de Hierro-Segovia de Arana(IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, 28222 Madrid, Spain.
  2. 2Medicine Department, Facultad de Medicina, Universidad Autónoma de Madrid, 28029 Madrid, Spain.
  3. 3Department of Nephrology, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain.
  4. 4Department of Nephrology, Hospital Universitario Clinico San Carlos de Madrid, 28040 Madrid, Spain.
  5. 5Department of Nephrology, Hospital Universitario Doce de Octubre, 28041 Madrid, Spain.
  6. 6Department of Nephrology, Hospital Universitario La Paz, 28046 Madrid, Spain.
  7. 7Department of Nephrology, Hospital Universitario de la Princesa, ISS-Princesa, 28006 Madrid, Spain.
  8. 8Department of Nephrology, Hospital Universitario Gregorio Marañon, 28007 Madrid, Spain.
  9. 9Department of Nephrology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
  10. 10Department of Nephrology, Hospital Universitario General de Segovia, 40002 Segovia, Spain.
  11. 11Department of Nephrology, Hospital Universitario Guadalajara, 19002 Guadalajara, Spain.
  12. 12Department of Nephrology, Hospital Universitario del Sureste, 28500 Madrid, Spain.
  13. 13Department of Nephrology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain.
  14. 14Department of Nephrology, Hospital Universitario Rio Carrión, 34004 Palencia, Spain.
  15. 15Department of Nephrology, Hospital Universitario Fundación Jiménez Diaz, 28040 Madrid, Spain.
  16. 16Department of Nephrology, Hospital Universitario Fundación Alcorcon, 28922 Madrid, Spain.
  17. 17Department of Nephrology, Hospital Universitario Getafe, 28905 Madrid, Spain.
  18. 18Department of Nephrology, Complejo Hospital Universitario Toledo, 45004 Toledo, Spain.
  19. 19Department of Nephrology, Hospital Universitario Villalba, 28400 Madrid, Spain.
  20. 20Department of Nephrology, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain.

Abstract

Background/Objectives: Frailty is increasingly recognized as a major determinant of adverse outcomes in patients receiving peritoneal dialysis (PD), yet it is not routinely incorporated into clinical practice. Because PD relies heavily on patient autonomy and self-management, frailty, sarcopenia, malnutrition, and impaired quality of life may compromise both outcomes and technique retention. This study aimed to describe current clinical practices related to frailty-informed assessment in PD units participating in the GCDP network and to identify barriers to implementing a more comprehensive, patient-centered approach. Methods: We conducted a descriptive, observational, cross-sectional study based on a survey distributed to PD units belonging to the Grupo Centro de Diálisis Peritoneal (GCDP), a collaborative network of 24 hospitals across four autonomous communities in Spain. Physicians and nurses completed the questionnaire between January and February 2025. The survey explored seven domains: use of frailty scales, nutritional screening tools, dynamometry, muscle ultrasound, bioimpedance, quality of life instruments, and digital applications for patient follow-up. Results: Twenty of 24 centers completed the survey. Although all units considered frailty clinically relevant, only 11 assessed it at PD initiation and only 5 performed periodic or systematic re-evaluation. Nutritional screening tools were used in 13 centers, most commonly the Malnutrition Inflammation Score. Twelve centers had a dynamometer, though its use was not standardized. All centers used bioimpedance-primarily for hydration assessment-while muscle ultrasound was rarely applied in scheduled follow-up. Only 7 centers assessed quality of life. The main reported barriers were lack of time in routine practice and the absence of specific guidelines and training. Conclusions: Frailty-related assessment across participating GCDP units remains heterogeneous and incompletely implemented despite broad recognition of its clinical relevance. The identified gaps in standardized protocols, training, and integration of assessment tools highlight priorities for future implementation research aimed at incorporating frailty-informed, patient-centered assessment into routine PD care.

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BibTeX
@article{garciamenendez2026frailtyinformed,
  title = {{Frailty-Informed Assessment in Peritoneal Dialysis: A Multicenter Survey of Current Practice and Implementation Barriers in Spain.}},
  author = {Estefanya García-Menéndez and Jose Portolés and Luisa Sánchez-García and Jesús Delgado and Paula Jara Caro Espada and Yanieli Hernández and Ana Sánchez Horrillo and Almudena Vega and R Haridian Sosa Barrios and María José Fernández-Reyes and Nerea Begoña Boldova and Fernando Tornero and Karen Rivero and Victoria Oviedo and Marina González de Rivera and Ana Tato and Laura Espinel and Laura Cueto and Laura Rodríguez-Osorio and Mayra Ortega and Paula López-Sánchez},
  journal = {Geriatrics (Basel, Switzerland)},
  year = {2026},
  month = oct,
  doi = {10.3390/geriatrics11050140},
  url = {https://europepmc.org/article/MED/42930019},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Frailty-Informed Assessment in Peritoneal Dialysis: A Multicenter Survey of Current Practice and Implementation Barriers in Spain.
AU  - Estefanya García-Menéndez
AU  - Jose Portolés
AU  - Luisa Sánchez-García
AU  - Jesús Delgado
AU  - Paula Jara Caro Espada
AU  - Yanieli Hernández
AU  - Ana Sánchez Horrillo
AU  - Almudena Vega
AU  - R Haridian Sosa Barrios
AU  - María José Fernández-Reyes
AU  - Nerea Begoña Boldova
AU  - Fernando Tornero
AU  - Karen Rivero
AU  - Victoria Oviedo
AU  - Marina González de Rivera
AU  - Ana Tato
AU  - Laura Espinel
AU  - Laura Cueto
AU  - Laura Rodríguez-Osorio
AU  - Mayra Ortega
AU  - Paula López-Sánchez
PY  - 2026
DA  - 2026/10/06
JO  - Geriatrics (Basel, Switzerland)
DO  - 10.3390/geriatrics11050140
UR  - https://europepmc.org/article/MED/42930019
AB  - Background/Objectives: Frailty is increasingly recognized as a major determinant of adverse outcomes in patients receiving peritoneal dialysis (PD), yet it is not routinely incorporated into clinical practice. Because PD relies heavily on patient autonomy and self-management, frailty, sarcopenia, malnutrition, and impaired quality of life may compromise both outcomes and technique retention. This study aimed to describe current clinical practices related to frailty-informed assessment in PD units participating in the GCDP network and to identify barriers to implementing a more comprehensive, patient-centered approach. Methods: We conducted a descriptive, observational, cross-sectional study based on a survey distributed to PD units belonging to the Grupo Centro de Diálisis Peritoneal (GCDP), a collaborative network of 24 hospitals across four autonomous communities in Spain. Physicians and nurses completed the questionnaire between January and February 2025. The survey explored seven domains: use of frailty scales, nutritional screening tools, dynamometry, muscle ultrasound, bioimpedance, quality of life instruments, and digital applications for patient follow-up. Results: Twenty of 24 centers completed the survey. Although all units considered frailty clinically relevant, only 11 assessed it at PD initiation and only 5 performed periodic or systematic re-evaluation. Nutritional screening tools were used in 13 centers, most commonly the Malnutrition Inflammation Score. Twelve centers had a dynamometer, though its use was not standardized. All centers used bioimpedance-primarily for hydration assessment-while muscle ultrasound was rarely applied in scheduled follow-up. Only 7 centers assessed quality of life. The main reported barriers were lack of time in routine practice and the absence of specific guidelines and training. Conclusions: Frailty-related assessment across participating GCDP units remains heterogeneous and incompletely implemented despite broad recognition of its clinical relevance. The identified gaps in standardized protocols, training, and integration of assessment tools highlight priorities for future implementation research aimed at incorporating frailty-informed, patient-centered assessment into routine PD care.
SN  - 2308-3417
ER  -