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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
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.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Polypharmacy is prevalent among older adults and is associated with adverse health outcomes. Prescribing patterns and the extent of polypharmacy in older patients with kidney failure are not well documented. This analysis examines medication use among older patients with kidney failure in Australia who are enrolled in the OUTcomes Of Older patients with Kidney failure (OUTLOOK) study.
OUTLOOK is a prospective observational cohort study conducted at 8 Australian sites. Inclusion criteria are adults ≥75 years with kidney failure (eGFR ≤15 mL/min/1.73 m2), who are either in the decision-making phase or have recently decided between conservative kidney management (CKM) and kidney replacement therapy (KRT), without having yet started dialysis or undergone kidney transplantation. This analysis examined baseline medication use, with polypharmacy defined as ≥5 medications and hyperpolypharmacy defined as ≥10 medications. Medications were classified according to Anatomical Therapeutic Chemical (ATC) classification codes. Frailty was defined using the Clinical Frailty Scale (CFS). Comorbidity burden was defined using the modified Charlson comorbidity index (mCCI). Logistic regression models were used to assess factors associated with polypharmacy and hyperpolypharmacy.
A total of 605 participants have been enrolled in OUTLOOK. At baseline, mean age was 83.1 years (standard deviation, SD 5.2), 43.5% were female, participants were predominantly community-dwelling (89.3%) and had a high prevalence of frailty (CFS ≥5, 50.6%). Comorbidity burden was high, with mean mCCI 8.1 (SD 1.9) and diabetes prevalence 47.8%. Mean eGFR was 11.3 mL/min/1.73 m2 (SD 2.8), with most patients having decided on their preferred kidney failure treatment pathway (66.0% opting for CKM, 15.2% planning for dialysis, 18.8% undecided). The mean number of prescribed medications was 9.1 (SD 3.9, range 0-24). Polypharmacy occurred in 90.1% of participants (n=545), and 43.5% (n=263) had hyperpolypharmacy. The five most prescribed medication classes were: diuretics, statins, dihydropyridine calcium channel blockers, beta-blockers and erythropoietin-stimulating agents (Table 1). When classified using ATC codes, cardiovascular medications were the most prescribed group (Figure 1). After adjusting for age, sex, race and baseline eGFR, the odds of polypharmacy increased with frailty (CFS ≥5) (adjusted odds ratio, OR 2.88, 95% confidence interval, CI 1.58-5.23, P<0.001) and high comorbidity (mCCI ≥9) (adjusted OR 3.66, 95% CI 1.81-7.42, P<0.001). Similarly, hyperpolypharmacy odds were greater with frailty (adjusted OR 1.72, 95% CI 1.23-2.41, P=0.001), high comorbidity (adjusted OR 2.10, 95% CI 1.50-2.96, P<0.001), and residential care (adjusted OR 2.13, 95% CI 1.23-3.70, P=0.007). There were no associations between planned treatment pathway (dialysis, CKM, or undecided) and odds of polypharmacy or hyperpolypharmacy.
In this multicentre cohort study of older patients with kidney failure in Australia, the prevalence of polypharmacy and hyperpolypharmacy were high and were associated with frailty, comorbidity burden and residential care. Follow-up data from this cohort will be completed in December 2025, offering important data on the associations of polypharmacy with clinical outcomes including mortality and guiding strategies to mitigate these risks in this vulnerable population.
