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Background <p>As life expectancy increases and more adults aged ≥ 65 years undergo continuous kidney replacement therapy (CKRT), grouping patients into narrower age groups—rather than treating those aged ≥ 65 years as a single category—can provide more precise insights into age-related mortality risks.</p> Methods <p>This consecutive, retrospective study examined adults aged ≥ 65 years who underwent CKRT for acute kidney injury (AKI) at a tertiary hospital between August 2017 and March 2024. Participants were stratified into three age groups; 65–74 years, 75–84 years, and ≥ 85 years. The outcomes included 48-hour, 7-day, and in-hospital mortality. Logistic regression analysis was used to identify the impact of stratified age on mortality and the factors associated with age-specific mortality in each group.</p> Results <p>Among the 1017 eligible patients, 292 (28.7%) died within 48&#xa0;h, 402 (39.5%) within 7 days, and 607 (59.7%) during hospitalization. Compared with patients aged 65–74 years, those aged 75–84 years and those aged ≥ 85 years did not have an increased risk of 48-h, 7-day, or in-hospital mortality after adjustment for clinical variables. In patients aged 75–84 years, a higher serum albumin level was independently associated with lower in-hospital mortality (adjusted odds ratio [aOR], 0.35; 95% confidence interval [CI], 0.16–0.70; <i>P</i> = 0.004). In patients aged ≥ 85 years, a higher body mass index was significantly associated with reduced 7-day mortality (aOR, 0.74; 95% CI, 0.52–0.95; <i>P</i> = 0.037) and in-hospital mortality (aOR, 0.65; 95% CI, 0.43–0.87; <i>P</i> = 0.014).</p> Conclusions <p>In adults aged ≥ 65 years undergoing CKRT, advanced age was not associated with increased risk of early or in-hospital mortality. Among those aged ≥ 75 years, indicators of baseline health and nutrition status were associated with mortality. Age alone should not preclude CKRT decision-making in patients aged ≥ 65 years with AKI.</p>

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Age-stratified mortality and associated risk factors in adults aged 65 years or older undergoing continuous kidney replacement therapy: a consecutive retrospective study

  • 期刊论文

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  • 发表日期：

    2025年11月19日

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  • Seong-Wook Lee,
  • Yu Jin Seo,
  • Jeong-Hoon Lim,
  • Ji-Young Choi,
  • Jang-Hee Cho,
  • Sun-Hee Park,
  • Chan-Duck Kim,
  • Yong-Lim Kim,
  • Hee-Yeon Jung

摘要

Background

As life expectancy increases and more adults aged ≥ 65 years undergo continuous kidney replacement therapy (CKRT), grouping patients into narrower age groups—rather than treating those aged ≥ 65 years as a single category—can provide more precise insights into age-related mortality risks.

Methods

This consecutive, retrospective study examined adults aged ≥ 65 years who underwent CKRT for acute kidney injury (AKI) at a tertiary hospital between August 2017 and March 2024. Participants were stratified into three age groups; 65–74 years, 75–84 years, and ≥ 85 years. The outcomes included 48-hour, 7-day, and in-hospital mortality. Logistic regression analysis was used to identify the impact of stratified age on mortality and the factors associated with age-specific mortality in each group.

Results

Among the 1017 eligible patients, 292 (28.7%) died within 48 h, 402 (39.5%) within 7 days, and 607 (59.7%) during hospitalization. Compared with patients aged 65–74 years, those aged 75–84 years and those aged ≥ 85 years did not have an increased risk of 48-h, 7-day, or in-hospital mortality after adjustment for clinical variables. In patients aged 75–84 years, a higher serum albumin level was independently associated with lower in-hospital mortality (adjusted odds ratio [aOR], 0.35; 95% confidence interval [CI], 0.16–0.70; P = 0.004). In patients aged ≥ 85 years, a higher body mass index was significantly associated with reduced 7-day mortality (aOR, 0.74; 95% CI, 0.52–0.95; P = 0.037) and in-hospital mortality (aOR, 0.65; 95% CI, 0.43–0.87; P = 0.014).

Conclusions

In adults aged ≥ 65 years undergoing CKRT, advanced age was not associated with increased risk of early or in-hospital mortality. Among those aged ≥ 75 years, indicators of baseline health and nutrition status were associated with mortality. Age alone should not preclude CKRT decision-making in patients aged ≥ 65 years with AKI.