With increasing global life expectancy, the prognostic significance of #kidney function in centenarians and supercentenarians should be clarified. The conventional estimated glomerular filtration rate ( #eGFR ) threshold of < 60 mL/min/1.73 m2 may not accurately reflect chronic kidney disease (CKD) in this population, highlighting the need for age-adapted definitions. This study investigated the association of kidney function with all-cause mortality across three age groups. Data from the Tokyo Centenarian Study, Japan Semi-supercentenarian Study, and Kawasaki Ageing and Wellbeing Project were analyzed in 1,918 participants with baseline serum creatinine measurements were included (median follow-up: 1,399 days). eGFR was calculated using creatinine and cystatin C according to the Japanese Society of Nephrology equation. Associations with mortality were assessed using Cox regression models, and standardized 3-year absolute risks were estimated. Lower cystatin C-based eGFR was consistently associated with higher mortality, whereas creatinine-based eGFR showed weaker associations. Prognostic thresholds for eGFR declined with advancing age-approximately 45, 30, and 15 mL/min/1.73 m2 at ages 85-89, 100-104, and ≥ 105 years, respectively. The 3-year absolute risk difference (ARD) between the low and high eGFR groups was modest (≈10%) at ages 85-89 years, larger (≈30%) at 100-104 years, and attenuated at ≥ 105 years, where the 3-year mortality exceeded 80%. eGFR remained a prognostically relevant marker in very old individuals; however, the magnitude of ARDs varied by age-modest in the younger-old adults, larger in centenarians, and attenuated in semi- and supercentenarians-supporting the adoption of age-specific CKD thresholds.
2 Medical News 