The influence of age on renal outcomes in patients with stage 2-4 chronic kidney disease
10.3760/cma.j.cn431274-20230510-00670
- VernacularTitle:年龄对2～4期慢性肾脏病患者肾脏结局的影响
- Author:
Xingtong DONG
1
;
Qi PANG
;
Na LIN
;
Wen LI
;
Wenjing FU
;
Aihua ZHANG
Author Information
1. 首都医科大学宣武医院肾病内科，北京 100053
- Keywords:
Chronic kidney disease;
Age factors;
End-stage renal disease
- From:
Journal of Chinese Physician
2023;25(12):1789-1793
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the correlation between age and renal outcomes in patients with stage 2-4 chronic kidney disease (CKD) and the impact of age on CKD outcomes in kidney diseases of different etiologies.Methods:A prospective cohort study included 470 patients with stage 2-4 CKD. The Kaplan Meier method was used to analyze the differences in CKD outcomes among different age groups. The independent risk factors for CKD progression were analyzed using a multivariate Cox regression model. We adjusted for baseline differences in risk factors for CKD outcomes between two age groups using propensity score matching (PSM).Results:Among 470 patients, 39 cases of end-stage renal disease (ESRD) events (all starting dialysis) and 51 deaths were observed. The Kaplan Meier survival curve ( P=0.039) and Cox regression univariate survival analysis ( P=0.043) both showed that <60 years old is a risk factor for CKD patients to progress to ESRD. In multivariate Cox regression, age remained an independent risk factor for the progression of CKD patients (hazard ratio 0.386, 95% CI: 0.163-0.916; P=0.031). For kidney diseases with different causes, in patients with hypertensive kidney damage ( P=0.024) and primary glomerulonephritis ( P=0.047), the cumulative incidence rate of ESRD in patients <60 years old was higher than that in patients ≥60 years old. There was no statistically significant difference in all-cause mortality rates between patients aged <60 and ≥60 years old ( P=0.646). Conclusions:Elderly patients with stage 2-4 CKD have a lower ESRD risk than younger patients. This discovery helps nephrologists and decision-makers optimize the management of elderly CKD patients.
