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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Hospitalisation for fluid overload (FO) among individuals with chronic kidney disease (CKD) may be associated with increased mortality. To enable meaningful comparisons of mortality with populations with different age structures, we aimed to describe the age-standardised mortality rates (ASMRs) and age-specific mortality rate of individuals with CKD and fluid overload-related hospitalizations.
We performed a single-centre retrospective study of patients aged ≥50 years with reduced kidney function (eGFR 10-59 ml/min/1.73m2) with fluid overload-related hospitalizations at Singapore General Hospital between November 2021 to December 2023, using electronic medical records data. Fluid overload-related hospitalisations were identified via ICD-10 codes. Patients with eGFR <10 ml/min/1.73m2, on dialysis or palliative care were excluded.
ASMRs and age-specific mortality rates, weighted by person-time, were calculated for 2023 and compared with the general population, using data from Singapore Department of Statistics (SINGSTAT). ASMRs were standardised to the 2023 resident population, and reported for individuals aged ≥50 years.
We included 2,220 patients with fluid overload-related hospitalisations. Mortality in our study cohort was elevated compared to the general population (ASMR 243.9 vs 15.1 per 1,000 person-years). Age-specific mortality rates of the study cohort was 43 to 47 times of the general population for the age groups between 50 and 64 years old and 18 to 31 times of the general population for the age groups between 65 and 74 years old (Table 1, Figure 1).
Table 1. Age-specific Mortality Rates (per 1,000 person-year) in the Study cohort and General population in 2023
Age Group*
CKD with Fluid overload Hospitalizations
General Population
Age-specific MRR‡
Cases
Deaths
Person-years
Age-specific Mortality Rates†
50-54
59
4
41.4
96.6
2.2
43.9
55-59
90
11
62.5
176.0
3.7
47.6
60-64
134
24
92.2
260.2
6.0
43.4
65-69
195
40
131.4
304.3
9.8
31.1
70-74
304
57
196.8
289.7
15.4
18.8
75-79
392
89
249.6
356.7
26.9
13.3
80-84
406
254.9
349.1
51.7
6.8
85-89
351
82
227.9
359.9
96.3
>90
289
99
156.7
631.8
177.3
3.6
*Age in years, †Age-specific mortality rate, per 1,000 person-years, ‡Age-specific mortality rate ratio
Subgroup analyses were performed by severely reduced renal function (eGFR <30 ml/min/1.73m2; Figure 2) and diabetes mellitus (DM) status (Figure 3). Mortality increased with age and was higher amongst patients with severely reduced renal function (eGFR <30) in older age groups (≥75 years), with age-specific mortality rate ratios (MRR) ranging 1.19 to 1.81. Among patients with diabetes, mortality was lower than in non-diabetic patients for ages 50-64 (MRR 0.16-0.48), comparable in ages 65-74 (MRR 0.81-1.01) and generally higher in ages ≥75 (MRR 1.16-1.39).
CKD patients hospitalised for fluid overload have significantly elevated mortality compared to the general population. Severely reduced kidney function and diabetes confer additional, age-dependent risk, particularly among elderly patients, highlighting the need for targeted monitoring and intervention strategies in these high-risk subgroups.
