Development and validation of a nomogram for identifying pre-frailty risk in middle-aged and elderly maintenance hemodialysis patients: a cross-sectional study
Year: 2026
Type: article
Study design: Observational Study
Abstract: AIM: This study aimed to develop a nomogram for screening the risk of pre-frailty in middle-aged and elderly patients on maintenance hemodialysis (MHD) based on cross-sectional data. DESIGN: An explorative cross-sectional design was adopted. METHODS: From August 2024 to December 2024, 181 participants were recruited from a hemodialysis center in Chengdu, Sichuan Province, China, via convenience sampling. The Frailty Screening Inventory (FRAIL) was used to screen subjects for pre-frailty, leading to the formation of two groups: the pre-frailty group and the non-pre-frailty group. Univariate analysis and multivariate binary logistic regression were used to identify predictors. RStudio (version 4.2.1) was subsequently used to construct the regression model and generate the nomogram. RESULTS: The prevalence of pre-frailty among middle-aged and elderly MHD patients was 71.27%. Logistic regression analysis revealed that employment status (retirement), weekly exercise frequency (≤ 2 times/week), presence of hyposomnia, high activities of daily living (ADL) score, presence of multiple complications, and low albumin (ALB) levels were independently associated with increased risk of pre-frailty. Furthermore, the Hosmer–Lemeshow goodness-of-fit test yielded a statistic of χ²=1.774 (P = 0.987), and the area under the receiver operating characteristic (ROC) curve was 0.929 (95% CI: 0.892–0.965). At a cut-off value of 0.648, the Youden index reached its maximum of 0.745, with a sensitivity of 0.846 and a specificity of 0.899. CONCLUSION: Pre-frailty is common in middle-aged and elderly MHD patients. In this study, we developed a column chart of six risk factors, which showed good predictive power. The use of this tool facilitates the early identification of patients at high risk for pre-frailty. IMPACT: This study developed a tool for clinical healthcare professionals to predict the probability and risk factors for pre-frailty in middle-aged and elderly MHD patients. The nomogram allows for personalized intervention. PATIENT OR PUBLIC CONTRIBUTION: Data were collected from patients on MHD via a questionnaire survey. REPORTING METHOD: The TRIPOD checklist. was used. CLINICAL TRIAL NUMBER: Not applicable.
Source: BMC Nephrology
Authors: Ying Luo, Jie Li, Yue Gao, Huaihong Yuan
Institutions: Sichuan University, West China Hospital of Sichuan University
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7141271115