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<p>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 &lt; 60&#xa0;mL/min/1.73 m<sup>2</sup> 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&#xa0;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&#xa0;mL/min/1.73 m<sup>2</sup> at ages 85–89, 100–104, and ≥ 105&#xa0;years, respectively. The 3-year absolute risk difference (ARD) between the low and high eGFR groups was modest (≈10%) at ages 85–89&#xa0;years, larger (≈30%) at 100–104&#xa0;years, and attenuated at ≥ 105&#xa0;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.</p> Graphical Abstract <p></p>

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Kidney function and all-cause mortality in the oldest-old population: a three-cohort longitudinal study

  • 期刊论文

  • 发表日期：

    2026年2月9日

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  • Hideaki Kurata,
  • Shu Meguro,
  • Yukiko Abe,
  • Takashi Sasaki,
  • Yasumichi Arai,
  • Nobuyoshi Hirose,
  • Kaori Hayashi

摘要

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.

Graphical Abstract