Abstract P330: Chronic Kidney Disease is Associated With Short-Term Risk of Hospitalization Among Older Adults

Abstract

Background: Chronic kidney disease (CKD) is now staged by estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR). Risks of cardiovascular disease, dialysis, and mortality are well described, but risks of hospitalization at older age have not been explored to the same depths. Hypothesis: CKD stages will be associated with risk of all-cause hospitalizations. Methods: The analysis was conducted on 5669 white and African-American participants of the ARIC Visit 5 (2011-2013) cohort (mean age, 76 y; female, 57%; African-American, 23%). CKD was staged according to KDIGO 2012 criteria with eGFR from serum cystatin C (eGFRcys) and ACR. The primary outcome of all-cause hospitalization risk was analyzed by using negative binomial regression to estimate incidence rate ratios (IRR), adjusted for demographics, behaviors, and comorbidities. Results: Over a median follow-up period of 3.5 years (by December 31 st , 2015), 6124 hospitalizations occurred over 19788 person-years (Crude Incidence Rate, 309 per 1000 person-years). Risk of hospitalization increased markedly with lower eGFRcys and higher albuminuria ( Table 1 ). Other baseline comorbidities were also associated with hospitalization risk (IRR [95% CI] for heart failure, coronary heart disease (CHD), stroke, cancer were 1.7 [1.4-2.0], 1.5 [1.3-1.7], 1.3 [1.1-1.6], and 1.2 [0.9-1.5]). Conclusions: Among older adults, both low eGFR and high ACR are strongly related to risk of hospitalization. These findings provide insight for risk stratification and prevention of CKD at older ages. Table 1. Risk of hospitalization by CKD stages defined by eGFR and ACR