A new study published today suggests that those over 65 with stage 4 chronic kidney disease (CKD) are more likely to die than to experience kidney failure.

This suggests that more people die with CKD rather than because of kidney failure.

Professor Matthew Jose, of the University of Tasmania and Royal Hobart Hospital, and colleagues examined linked data from the Tasmanian Chronic Kidney Disease study, which included all Tasmanian adults diagnosed with incident stage 4 chronic kidney disease between January 1, 2004 and December 31, 2017.

The data was analyzed for a total of 6825 adults (mean age, 79.3 years; SD, 11.1 years), including 3816 women (55.9%).

“The risk of death increased with age — under 65 years: 0.18 (95% CI, 0.15–0.22); 65‒74 years: 0.39 (95% CI, 0.36‒0.42); 75‒84 years, 0.56 (95% CI, 0.54‒0.58); 85 years or older: 0.78 (95% CI, 0.77‒0.80) — while that of kidney failure declined — under 65 years: 0.39 (95% CI, 0.35–0.43); 65‒74 years: 0.12 (95% CI, 0.10‒0.14); 75‒84 years: 0.05 (95% CI, 0.04‒0.06); 85 years or older: 0.01 (95% CI, 0.01‒0.02),” the authors said.

“Three important conclusions can be drawn from our study: for people with stage 4 CKD, the 5-year risk of kidney failure declines with age; the risk of death is greater than that of kidney failure for those over 65 years of age; and the risks of death and kidney failure for people over 65 are each greater for men than women.

“People over 65 years of age with stage 4 CKD were more likely to die than to experience kidney failure, suggesting that more people die with CKD rather than directly because of CKD,” Jose and colleagues wrote.

“When kidney replacement therapy pathways are well defined and supported, disease management typically focuses on dialysis or transplantation; the pathway to supportive (non-dialysis) care is less well defined, and differences between renal units are greater.

“[…] mortality risks should be considered when discussing future kidney failure treatment options for patients over 65 years of age.”

Currently, healthcare recommendations urge that patients be directed to kidney specialists to prepare for kidney failure or transplantation.

Jose and colleagues wrote that their results of the study show that “clinical guidelines should recognise competing risks of death in older people with severe kidney disease, and consider holistic, supportive care, not just kidney replacement therapy.”

Source: 10.5694/mja2.51361

Image Credit: Getty

You were reading: Those over 65 are more likely to die with kidney disease than from it, says study