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Abstract: TH-PO775

A Population-Based Assessment of Kidney Function and the Risk of Heart Failure Among Older Adults

Session Information

Category: Geriatric Nephrology

  • 1200 Geriatric Nephrology

Authors

  • Douros, Antonios, McGill University, Montreal, Quebec, Canada
  • Schneider, Alice, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Mielke, Nina, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Kuhlmann, Martin K., Vivantes Netzwerk fur Gesundheit GmbH, Berlin, Berlin, Germany
  • van der Giet, Markus, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Ebert, Natalie, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Schaeffner, Elke, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
Background

Decreased kidney function (KF) increases the risk of heart failure (HF) and other adverse cardiovascular (CV) outcomes and death. However, the role of KF in this regard among old and very old adults is poorly understood. This is an important knowledge gap since the decline of KF in advanced age can affect both healthy and multimorbid individuals. Thus, our population-based study assessed whether decreased KF is associated with an increased risk of HF, CV and all-cause mortality in a prospective cohort of community-dwelling older adults.

Methods

Participants of the Berlin Initiative Study (BIS), all aged ≥70 years, with baseline estimated glomerular filtration rate (eGFRBIS2) and no prior HF were followed from baseline (2009-2011) until the occurrence of a study outcome (hospitalization for HF [HHF], CV death, all-cause mortality) or 12/2020. HHF was defined via inpatient diagnostic codes, and mortality outcomes were defined via claims data, death certificates, and hospital discharge notes. Potential confounders included demographics, body mass index, alcohol consumption, smoking, physical exercise, education, income, comedications and comorbidities, measured at baseline using face-to-face interviews and claims data. Time-dependent Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) of the outcomes associated with decreased KF (eGFRBIS2 <60mL/min/1.73m2) compared with retained KF (eGFRBIS2 ≥60mL/min/1.73m2). eGFR values were updated biennialy.

Results

Our cohort included 1466 HF free older adults (mean age 79 years; 55% female). Compared with retained KF, decreased KF was not associated with an increased risk of HHF (HR, 1.17; CI, 0.92-1.49), but was associated with increased risks of CV death (HR, 1.59; CI, 1.01-2.50), and all-cause mortality (HR, 1.33; CI, 1.02-1.72) (Figure).

Conclusion

Our population-based study showed that decreased KF is associated with an increased risk of CV and all-cause death among older adults. The role of HF in this association seems to be limited.

Risk of outcomes with decreased KF among older adults

Funding

  • Private Foundation Support