AGNES—AGing NEphropathy study—a prospective cohort of older patients with advanced chronic kidney disease.
Background In older patients with chronic kidney disease (CKD), comorbidities, functional status, nutritional patterns and sleep disorders should be considered in the individualised shared decision-making process to initiate dialysis. We conducted a prospective cohort study to assess independent fac...
| Publicado en: | Age & Ageing Vol. 55; no. 2; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Feb2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192513172&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192513172 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Feb2026 vid: 55 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 192513172 10.1093/ageing/afag044 ppf: 1 ppct: 9 formats: tig: atl: AGNES—AGing NEphropathy study—a prospective cohort of older patients with advanced chronic kidney disease. aug: au: Lauar, Julia C Coelho, Venceslau A Innecchi, Mariana R Costa, Tiago E Araujo, Luiza K R P Avesani, Carla Stenvinkel, Peter Lindholm, Benght Moyses, Rosa M Elias, Rosilene M affil: Department of Internal Medicine, Nephrology, Universidade de Sao Paulo, São Paulo, SP, Brazil Department of Geriatrics, Universidade de Sao Paulo, Sao Paulo, SP, Brazil Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stokholm, Sweden su: Brazil Old age Chronic kidney failure complications Mortality risk factors Risk assessment Creatinine Bone density Outpatient services in hospitals Data analysis Research funding Scientific observation Questionnaires Multiple regression analysis ACE inhibitors Hemodialysis Descriptive statistics Longitudinal method Odds ratio Angiotensin receptors Kaplan-Meier estimator Adrenergic beta blockers Statistics Geriatric Depression Scale Confidence intervals Data analysis software Sleep disorders Biomarkers Diet Comorbidity Disease complications sug: subj: Old age Brazil Kidney Dialysis Centers All Other Outpatient Care Centers Chronic kidney failure complications Mortality risk factors Risk assessment Creatinine Bone density Outpatient services in hospitals Data analysis Research funding Scientific observation Questionnaires Multiple regression analysis ACE inhibitors Hemodialysis Descriptive statistics Longitudinal method Odds ratio Angiotensin receptors Kaplan-Meier estimator Adrenergic beta blockers Statistics Geriatric Depression Scale Confidence intervals Data analysis software Sleep disorders Biomarkers Diet Comorbidity Disease complications keyword: aging angiotensin-converting enzyme inhibitors beta-blockers chronic chronic kidney disease comorbidity copyrightHolder:British Geriatrics Society copyrightYear:2026 creatinine death dialysis excessive daytime sleepiness hemodialysis https://dx.doi.org/10.1093/ageing/afag044 hypersomnolence inLanguage:en kidney diseases kidney failure older adult older people publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41766588/ aging angiotensin-converting enzyme inhibitors beta-blockers chronic chronic kidney disease comorbidity copyrightHolder:British Geriatrics Society copyrightYear:2026 creatinine death dialysis excessive daytime sleepiness hemodialysis https://dx.doi.org/10.1093/ageing/afag044 hypersomnolence inLanguage:en kidney diseases kidney failure older adult older people publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/41766588/ ab: Background In older patients with chronic kidney disease (CKD), comorbidities, functional status, nutritional patterns and sleep disorders should be considered in the individualised shared decision-making process to initiate dialysis. We conducted a prospective cohort study to assess independent factors related to dialysis initiation or death. Methods Single centre observational study that included patients ≥70 years with stage 4–5 CKD undergoing conservative management. We evaluated sleep disorders, nutritional markers, and bone biomarkers. Results In total, 150 patients (81 ± 7 years, Charlson score 7.8 ± 1.6, followed for a median of 1.8 years). At 2 years, 90 patients (60%) were alive and not on dialysis, 25 (16.7%) started dialysis, and 35 (23.3%) died. In a multivariable multinomial regression model, higher creatinine [OR 2.38 (1.49–3.80), P = .001] and excessive daytime sleepiness [OR 7.47 (1.86–30.00), P = .018] increased the likelihood of dialysis, while higher Charlson comorbidity scores [OR 1.49 (1.08–2.05), P = .049] and beta-blocker use [OR 4.93 (1.58–15.39), P = .019] increased the risk of death. Patients using angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI-ARB) had a lower probability of requiring dialysis (P = .005) and a lower probability of death (P = .005). Conclusion In older patients with advanced CKD, comorbidity burden and beta-blocker use were associated with an increased risk of death, whereas ACEI/ARB use was linked to a lower likelihood of both dialysis initiation and death. These findings highlight the importance of a comprehensive, multidimensional approach that integrates clinical, functional, and therapeutic factors to better inform individualised care and enhance outcomes in this population. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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