EPIDEMIOLOGY OF CHRONIC KIDNEY DISEASE AND COMORBID ILLNESS IN HOSPITALIZED GERIATRIC PATIENTS

Abstract

Background and aims: The number of older people in Europe is expanding. Although chronic kidney disease (CKD) becomes more common with increasing age, data concerning epidemiology of CKD in older people are scarce, especially in Eastern Europe countries. In the current analysis, we aimed to fill the gap on CKD epidemiology in older people from Romania, by describing a large population of hospitalized geriatric patients. Material and methods: In this retrospective cohort study we included all patients aged ≥ 65 years hospitalized in the Geriatric Department of “Dr. C. I. Parhon” Hospital from Iași, Romania, between 2012 – 2022. CKD was identified as decreased estimated glomerular filtration rate (<60 mL/min/1.73 m²) according to CKD-EPI equation. Investigated comorbid conditions included diabetes mellitus, hypertension/hypertensive heart disease, coronary artery disease, congestive heart failure, atrial fibrillation, chronic respiratory failure and anemia. Results: 3,563 geriatric patients (59.2% females) were hospitalized between 2012-2022. 3116 patients (87.4% of the total population) had a serum creatinine assay. Among these patients, the prevalence of CKD using the CKD-EPI equation was 38%. We found an unequal annually distribution between the number of patients with a diagnosis of CKD according to electronic health records and the number of patients with estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². 86,7% of the patients with eGFR < 60 mL/min/1.73 m² had at least 2 comorbidities. Only 2,4% of the patients with eGFR < 60 mL/min had no other chronic condition. Conclusions: In Romanian older hospitalized patients, the prevalence of individuals with eGFR <60 mL/min/1.73 m2 is higher than previous reports from our country. In geriatric adults, CKD is not an isolated entity, and the burden of cardiovascular comorbid illness is high.