时间标签：数据日期 2026-10-31 · 生成时间 2026-11-01 05:30（Asia/Shanghai）｜ 检索窗口 PubMed edat 2026/10/28–2026/10/31 ｜ 情报发生日期 2026-10-31
研究问题
As life expectancy improves, the proportion of the population aged ≥90 years is increasing in the US and is associated with a rising prevalence of chronic kidney disease., Despite being one of the fastest-growing population segments, contemporary data on outcomes of kidney failure in this subgroup are very limited., , , Decisions surrounding the initiation of dialysis in those aged ≥90 years are hampered by a lack of specific data on the subsequent typical course experienced, including survival, rates of hospitalization, and dialysis withdrawal.；To address some of these questions, we set out to characterize temporal trends in outcomes among nonagenarians with kidney failure in the US ().
方法
A total of 21,530 United States Renal Data System participants aged ≥90 years were included.；Frequencies of study participants by era were: 2006–2009 (n = 5015), 2010–2013 (n = 5518), 2014–2017 (n = 5505) and 2018–2021 (n = 5492).；Of the entire cohort, 42.89% were female, 76.77% were White, 14.82% were African American, 8.06% were Hispanic, and 72.63% were from the Northeast region; 55.36% had their primary kidney disease attributed to hypertension, and 30.8% had diabetes. 92.78% had Medicare coverage, 84.1% had a dialysis catheter as vascular access, 11.97% had an arteriovenous fistula or graft for access, and 3.94% were on peritoneal dialysis.
核心结论
Of the entire cohort, 42.89% were female, 76.77% were White, 14.82% were African American, 8.06% were Hispanic, and 72.63% were from the Northeast region; 55.36% had their primary kidney disease attributed to hypertension, and 30.8% had diabetes. 92.78% had Medicare coverage, 84.1% had a dialysis catheter as vascular access, 11.97% had an arteriovenous fistula or graft for access, and 3.94% were on peritoneal dialysis.；Adjusted risk of death rate fell over successive eras and was associated with sex (lower in females); race (lower risk in African American and other races compared with White race); primary cause of end-stage kidney disease (lower risk with hypertension, glomerulonephritis, and cystic disease, and higher in other cause category, compared with diabetes as primary cause of kidney failure); Medicare coverage (higher risk with Medicare coverage); dialysis modality (lower risk with peritoneal dialysis); estimated glomerular filtration rate < 10 ml/min per 1.73 m2 (lower risk with estimated glomerular filtration rate < 10 ml/min per 1.73 m2 compared with ≥ 10 ml/min per 1.73 ‖ 结论：This study provides vital natural history information for patients, families, and clinicians to engage in meaningful shared decision-making, balancing the potential for extended life with the realities of the treatment burden.
局限
Our study has limitations, among which are the registry-based and retrospective design, and the inability to compare conservative management in this age group because of the lack of capture of kidney failure cases not treated with dialysis.；Despite its limitations, our study is, to our knowledge, the largest to date on nonagenarian dialysis initiates and may provide estimates for the outcomes of interest for both patients and providers.
对本项目的价值
★☆☆☆☆ 相关范围内，作为背景与横向对照收录。
全文来源
PMC JATS 全文（正文 5,838 字符，已过标题/DOI 逐字归属校验）
原文题录
- 英文标题：Outcomes of Nonagenarians Commencing Dialysis by Era in the USA.
- 期刊与标识：Kidney Int Rep · PMID 42964315 · DOI 10.1016/j.ekir.2026.107040
A 级证据分级：A 级（同行评议人体研究）
本文属人体研究证据，但需注意：观察性或小样本干预的结论不等于已证实临床获益；效应量与长期安全性仍需更大规模、更长随访的试验验证。
关于本文的文献来源：本站依据 IMA 知识库「五刊监控·深度文献卡片」撰写，依据已获取的期刊全文（方法、样本量与结论已回到原文核对）；未能获取全文的同批条目另行标注「摘要级」，全程未做任何数值推算补全。