Abstract: TH-PO0313
Despite Heart Failure, Elderly Patients on Hemodialysis Show Meaningful Survival and Stable Quality of Life
Session Information
- Hypertension and CVD: Clinical - 1
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Santos Araujo, Carla Alexandra R., Chief Medical Office Diaverum M42, Malmo, Sweden
- Silva, Eliana, Chief Medical Office Diaverum M42, Malmo, Sweden
- Lucas, Carlos, Chief Medical Office Diaverum M42, Malmo, Sweden
- Macario, Fernando Jose Gordinho Rocha M, Chief Medical Office Diaverum M42, Malmo, Sweden
Background
Congestive heart failure (CHF) and chronic kidney disease commonly coexist, particularly in the elderly, and their combination is associated with poorer clinical outcomes. Despite the high prevalence of both conditions in this population, there is limited evidence on how pre-existing CHF influences outcomes in older adults beginning hemodialysis (HD), which complicates treatment decisions. This study aims to evaluate the impact of CHF on survival among patients aged 75 years and older who are newly starting HD.
Methods
Multicenter, prospective observational study, including patients aged ≥75 years who initiated HD in 2023 across 20 countries in a large dialysis provider. Patients were followed until December 2024, and stratified at dialysis start by the presence or absence of CHF. Baseline demographic, clinical, and laboratory parameters were recorded. Quality of life (QoL) KDQOL-36 Mental (MCS) and Physical Composite Scales (PCS) were considered and compared for patients alive in 2024. Survival was estimated by Kaplan–Meier analysis and Cox proportional-hazards models were used to quantify the association between CHF and mortality.
Results
3,218 patients were included in the study cohort: 1,043 (32%) had CHF. Patients with CHF at baseline were older (mean age 81.0±4.27 vs. 80.4±4.22, p<0.01), and had a higher proportion of females (41.2% vs. 37.5%, p<0.01) and diabetic patients (55.6% vs. 41.0%, p<0.01) compared to those without CHF. In multivariable cox regression adjusted for demographic, clinical and analytic variables, CHF was independently associated with increased mortality risk (HR 1.24; 95% CI, 1.07–1.55). Despite this, survival in the CHF group at two years, was 69.6% (95% CI, 0.68-0.72). No differences in MCS and PCS were observed between the two groups in 2024.
Conclusion
In patients aged 75 and older starting hemodialysis, the presence of pre-existing CHF was linked to a notably higher risk of mortality. Nevertheless, approximately 70% of patients with CHF survived two years, and quality of life measures did not differ significantly between those with and without CHF. These findings highlight that, despite the adverse prognostic implications of CHF, initiating HD in this older population may still confer meaningful benefits in terms of both survival and QoL.