Abstract: SA-PO1120
Identifying a Predictive Biomarker for Kidney Decline and Cardiovascular Risk in Older Adults: Evidence from a Large Cohort Study
Session Information
- Geriatric Nephrology
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1300 Geriatric Nephrology
Authors
- Gembillo, Guido, Universita degli Studi di Messina, Messina, Sicily, Italy
- Soraci, Luca, Italian National Institute of Health and Science on Aging (INRCA IRCCS), Cosenza, Italy
- Corsonello, Andrea, Italian National Institute of Health and Science on Aging (INRCA IRCCS), Cosenza, Italy
- Santoro, Domenico, Universita degli Studi di Messina, Messina, Sicily, Italy
Background
Cardiovascular disease (CVD) and CKD are leading causes of death and morbidity worldwide, affecting public health and healthcare systems. Our study examines the association between monocytes to high-density lipoproteins (MHR), kidney function, mortality, and the incidence of CVD using data from the Health and Retirement Study (HRS).
Methods
We analyzed data from 6,453 older adults enrolled in the HRS Study, including information on renal function, chronic disease history, and 4-year mortality outcomes. MHR was examined both as a continuous variable and in tertiles. Cross-sectional associations between MHR and eGFR were assessed using weighted linear regression, while the longitudinal relationship with mortality and heart disease incidence was evaluated with weighted Cox regression and Fine Gray models. Covariates included age, sex, ethnicity, smoking status, baseline chronic disease history, baseline eGFR, NLR ratio, and hb levels.
Results
The median MHR in the study cohort was 0.40 (range: 0.31–0.47). A higher MHR was significantly associated with a decline in eGFR in multivariate linear regression (β = -1.56, SE = 0.35, p < 0.001). Specifically, patients in the second (MHR 0.30–0.46) and third tertiles (MHR 0.47–6.45) exhibited a graded reduction in eGFR compared to those in the first tertile (MHR 0.1–0.29) (β = -1.40, SE = 0.58, p = 0.036; and β = -2.89, SE = 0.65, p < 0.001, respectively). Longitudinal analysis revealed that MHR was strongly predictive of all-cause mortality (HR = 1.52, 95% CI: 1.06–2.18) and was associated with several clinical factors, including age, lung disease, hypertension, stroke, NLR, and reduced hemoglobin. In a subgroup of patients without cardiovascular disease at baseline (n = 4,197), a higher MHR was linked to an increased incidence of CVD over 4 years (HR = 1.56, 95% CI: 1.26–2.24). A significant interaction was found between the highest MHR tertile and a diagnosis of CKD (p = 0.001), the associations were most pronounced in patients with CKD.
Conclusion
MHR is a strong integrative biomarker of inflammation and lipid dysregulation, independently linked to renal impairment and increased mortality risk in older adults. These associations are biologically and clinically significant, suggesting that MHR could be a valuable tool in geriatric and nephrologic risk assessment.