Ageing, advanced kidney disease and the limits of prediction: what AGNES tells us about decision-making.

The article focuses on the AGing NEphropathy Study (AGNES), a prospective cohort study of Brazilian adults aged 70 and older with advanced chronic kidney disease (CKD), examining factors influencing dialysis initiation and mortality over two years. AGNES found that most very old adults with advanced...

Descripción completa

Detalles Bibliográficos
Publicado en:Age & Ageing Vol. 55; no. 3; pp. 1 - 4
Autor principal: Holland, John
Formato: Artículo
Publicado: Oxford University Press / USA Mar2026
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=192797128&site=ehost-live
header:
  @attributes:
    shortDbName: ssf
    uiTerm: 192797128
    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: Mar2026
      vid: 55
      iid: 3
      pid: 622
      pub: Oxford University Press / USA
    artinfo:
      ui:
        192797128
        10.1093/ageing/afag059
      ppf: 1
      ppct: 3
      formats:
      tig:
        atl: Ageing, advanced kidney disease and the limits of prediction: what AGNES tells us about decision-making.
      aug:
        au: Holland, John
        affil: Guy's and St Thomas' Hospitals NHS Trust - Department of Transplant Surgery, Renal Medicine and Urology, London, England, United Kingdom of Great Britain and Northern IrelandKing's College London - School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, London, England, United Kingdom of Great Britain and Northern Ireland
      su:
        Health status indicators
        Decision making
        Prediction models
        Frail elderly
        Chronic kidney failure
        Cognition disorders
        Geriatric assessment
        Algorithms
        Comorbidity
        Phenotypes
        Biomarkers
      sug:
        subj:
          Health status indicators
          Decision making
          Prediction models
          Frail elderly
          Chronic kidney failure
          Cognition disorders
          Geriatric assessment
          Algorithms
          Comorbidity
          Phenotypes
          Biomarkers
      keyword:
        chronic kidney disease
        cognitive impairment
        comprehensive geriatric assessment
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        frailty
        https://dx.doi.org/10.1093/ageing/afag059
        inLanguage:en
        multiple long-term health conditions
        older people
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41848759/
        chronic kidney disease
        cognitive impairment
        comprehensive geriatric assessment
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        frailty
        https://dx.doi.org/10.1093/ageing/afag059
        inLanguage:en
        multiple long-term health conditions
        older people
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41848759/
      ab: The article focuses on the AGing NEphropathy Study (AGNES), a prospective cohort study of Brazilian adults aged 70 and older with advanced chronic kidney disease (CKD), examining factors influencing dialysis initiation and mortality over two years. AGNES found that most very old adults with advanced CKD neither started dialysis nor died within this period, highlighting that progression to dialysis is not inevitable and that comorbidity burden and symptom experience, particularly excessive daytime sleepiness, play a more significant role in outcomes and treatment decisions than biomarkers or geriatric measures alone. The study emphasizes the limitations of prediction-focused models in this complex population and supports the integration of renal-tailored comprehensive geriatric assessment (CGA) to enhance shared decision-making and care planning across dialysis and transplantation pathways. These findings advocate for a shift from kidney-centric approaches toward multidimensional, geriatric-informed care in managing older adults with advanced CKD.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
    refInfo:
    copyright:
      @attributes:
        flag: N
    holdings:
      @attributes:
        islocal: N