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Abstract: PO1370

Effect of Estimated Glomerular Filtration Rate on Survival in Patients ≥75 Years of Age at Dialysis Initiation

Session Information

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Hamroun, Aghiles, Centre Hospitalier Universitaire de Lille, Lille, Hauts-de-France, France
  • Bui, Linh, Paris Saclay University, Paris, France
  • Gomis, Sébastien, Centre Hospitalier Universitaire de Lille, Lille, Hauts-de-France, France
  • Glowacki, François, Centre Hospitalier Universitaire de Lille, Lille, Hauts-de-France, France
Background

Data regarding the prognostic impact of estimated glomerular filtration rate (eGFR) at dialysis start are discordant, and remain very scarce in elderly populations. The aim of this study is to explore whether the effect of eGFR on survival was similar in elderly incident dialysis patients compared with younger ones.

Methods

We included 4690 patients ≥75 years of age and 7045 patients 18-74 years of age starting dialysis between 2004 and 2018 from a French regional registry. Patients were followed until death or the end of 2019. Survival was assessed by Kaplan-Meier curves and the relative risk of death associated with eGFR (MDRD) was assessed by multivariate Cox regression analysis.

Results

The results showed an increasing trend of eGFR at dialysis start, which was also systematically higher in elderly patients (13.2 [10.1; 17.2] vs 11.2 [8.3; 14.9] ml/min/1.73m2, p < 0.001) (Fig1).
Overall, we found a significant dose-effect relationship between eGFR at dialysis initiation and mortality (HR = 1.33 [1.16; 1.51], 1.47 [1.29; 1.69], and 1.72 [1.49; 1.78] respectively for eGFR [5-10], [10-15], and > 15ml/min/1.73m2, p for trend < 0.001). The same results were found in subgroup analyses according to age category (Fig2), with a significant interaction in favor of a stronger association in younger patients (p = 0.031).

Conclusion

In incident dialysis patients, our study shows a dose-effect relationship between higher eGFR at dialysis start and mortality, regardless of age category. This association seems to be even stronger in younger patients.