Frailty is common in older people with chronic kidney disease, and comprehensive geriatric assessment is a logical intervention. A commentary reviews the GOAL trial, which tested whether it delivers.
According to the commentary, comprehensive geriatric assessment delivered as a single outpatient geriatrician appointment did not improve goal attainment for older people living with CKD and frailty. The author's reading is not that geriatric assessment is worthless, but that a one-off consultation is too thin an intervention, and that better-integrated, person-centred models need to be developed and tested.
The practical message is to resist the temptation to tick the box with a single geriatrician referral and expect benefit. Person-centred care for frail CKD patients should be built into the nephrology service as an ongoing model, and the evidence for how best to do that is still being written.
- Commentary on the GOAL trial of comprehensive geriatric assessment in CKD with frailty.
- A single outpatient geriatrician assessment did not improve goal attainment.
- The failure is read as the model being too thin, not the concept being wrong.
- Better-integrated, person-centred models still need evaluation.
- A one-off geriatrician referral should not be expected to deliver benefit on its own.
Why it matters
It warns against adopting a one-off geriatric assessment as a solution when the trial evidence shows it does not change outcomes.
Don't overread it
A negative result for a single-visit model does not mean comprehensive geriatric assessment or person-centred care is futile; it means this particular delivery did not work.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for nephrology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free