AGNES-AGing NEphropathy study-a prospective cohort of older patients with advanced chronic kidney disease.

At 2 years, the majority of older patients with advanced CKD on conservative management remained alive and not on dialysis, while significant proportions either started dialysis or died.

• 150 patients were enrolled with mean age 81 ± 7 years and Charlson comorbidity score of 7.8 ± 1.6
• Median follow-up was 1.8 years
• At 2 years, 90 patients (60%) were alive and not on dialysis
• 25 patients (16.7%) started dialysis and 35 patients (23.3%) died

Higher serum creatinine was independently associated with increased likelihood of dialysis initiation.

• OR 2.38 (95% CI 1.49–3.80), P = .001
• Finding derived from a multivariable multinomial regression model
• Study population included patients ≥70 years with stage 4–5 CKD undergoing conservative management

Excessive daytime sleepiness was independently associated with a markedly increased likelihood of dialysis initiation.

• OR 7.47 (95% CI 1.86–30.00), P = .018
• Finding derived from a multivariable multinomial regression model
• The study evaluated sleep disorders as part of a comprehensive multidimensional assessment including nutritional markers and bone biomarkers

Higher Charlson comorbidity scores were independently associated with increased risk of death.

• OR 1.49 (95% CI 1.08–2.05), P = .049
• Finding derived from a multivariable multinomial regression model
• Mean Charlson comorbidity score at baseline was 7.8 ± 1.6

Beta-blocker use was independently associated with increased risk of death in older patients with advanced CKD.

• OR 4.93 (95% CI 1.58–15.39), P = .019
• Finding derived from a multivariable multinomial regression model
• Beta-blocker use was identified as a therapeutic factor in the multidimensional assessment

ACEI/ARB use was associated with both a lower probability of requiring dialysis and a lower probability of death.

• Lower probability of requiring dialysis: P = .005
• Lower probability of death: P = .005
• Finding derived from a multivariable multinomial regression model in patients ≥70 years with stage 4–5 CKD