Abstract: FR-PO0544
Sex- and Age-Specific Cardiometabolic Comorbidity Patterns in Hospitalized Adults with CKD Stage 4
Session Information
- CKM: Clinical - Trials, Epidemiology, and Biomarkers
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Jahanshahi, Atousa, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
- Markovic, Daniela, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
- Nicholas, Susanne B., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
- Nobakht, Niloofar, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
Background
The American Heart Association cardiovascular-kidney-metabolic (CKM) framework highlights the convergence of chronic kidney disease (CKD), metabolic disease, and cardiovascular disease (CVD), yet sex- and age-specific comorbidity patterns and mortality in advanced CKD remain poorly characterized.
Methods
Using the UCLA Integrated Clinical and Research Data Repository (i2b2, 2015–2020), we identified hospitalized adults with CKD stage 4 and coexisting metabolic and cardiovascular disease. Patients were stratified by sex and age group (18–34, 35–54, 55+). Prevalence (%) of congestive heart failure (CHF), myocardial infarction (MI), peripheral vascular disease (PVD), cerebrovascular disease (CVD), diabetes with and without chronic complications, hypertension, obesity, and mortality was calculated within each category. Age-step prevalence changes (percentage-point deltas) were compared between sexes.
Results
Three distinct age- and sex-associated comorbidity patterns were observed. (1) Atherosclerotic pattern: MI and CVD prevalence increased progressively with age in both sexes, with higher prevalence in younger men. Women demonstrated larger age-step increases in MI, CVD, and PVD at the 35–54 to 55+ transition compared with men, and the MI sex gap narrowed from 8.9 percentage points at ages 18–34 to 5.5 at 55+. (2) Heart failure pattern: CHF prevalence was high and similar between sexes across all ages (62–73%), with a modest increase after age 55 in both sexes. (3) Metabolic pattern: diabetes with chronic complications peaked at ages 35–54 in both sexes then declined modestly in the 55+ group; obesity prevalence declined sharply after 55 (approximately 14–16 pp in both sexes). Mortality increased with age, exceeding 50% in women and 49% in men over age 55.
Conclusion
Distinct age- and sex-associated comorbidity patterns were observed in hospitalized adults with CKD stage 4. Women showed larger midlife increases in atherosclerotic comorbidity prevalence, while heart failure prevalence remained similar between sexes across age groups. Rising mortality with age suggests possible survivorship effects as a contributor to declining diabetes and obesity prevalence in older group. These findings highlight heterogeneity in comorbidity patterns within high risk CKM populations, and may help inform future studies of age- and sex-specific cardiometabolic risk stratification in CKD.