Introduction:
Introduction: Deciding between treatment pathways for older patients with kidney failure is challenging, in part due to limited high-quality outcome data. OUTcomes Of Older patients with Kidney failure (OUTLOOK) is an ongoing prospective observational cohort study enrolling Australian patients ≥75 years with kidney failure (estimated glomerular filtration rate ≤15 mL/min/1.73 m2). Patients are in the decision-making phase or have recently decided between kidney replacement therapy (KRT) or conservative kidney management (CKM). This analysis compares the OUTLOOK population with incident KRT patients aged ≥75 years in the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA).
Methods:
Methods: Baseline characteristics of currently enrolled participants in the OUTLOOK study are compared with incident KRT patients aged ≥75 years who entered ANZDATA between January 2015 to December 2022.
Results:
Results: 529 patients from a targeted 800 patients have been enrolled in OUTLOOK, and 5339 incident patients aged ≥75 years commenced KRT and entered onto ANZDATA in the study period. OUTLOOK patients were older (mean age 83.0 vs. 79.4 years, P<0.001), had higher female representation (43.1% vs. 30.6%, P<0.001), similar rates of diabetes (48.0% vs. 50.3%, P=0.87), and a higher proportion of unknown aetiology of kidney failure (24.2% vs. 1.3%, P<0.001). OUTLOOK patients were predominantly community-dwelling (89.2%) and functionally independent (56.3%), with a high prevalence of frailty (47.4%). 14.9% of OUTLOOK patients opted for a dialysis pathway, 65.4% for a CKM pathway, and 19.7% undecided, compared with 99.8% of the ANZDATA cohort undergoing dialysis and 0.2% undergoing kidney transplantation at KRT entry.
Conclusions:
Conclusions: Compared with the ≥75 years incident KRT population from ANZDATA, OUTLOOK captures an older, comorbid, predominantly community-dwelling cohort, with a high proportion of CKM as the chosen pathway of kidney failure management. OUTLOOK will therefore provide valuable prospective outcome data for an older Australian kidney failure cohort not otherwise captured in national registries.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.