Chronic Kidney Disease and Pharmacoepidemiology in Older Individuals: Challenges, Insights, and Therapeutic Advances

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: 15 September 2025 | Viewed by 844

Special Issue Editor


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Guest Editor
Unit of Geriatric Medicine, Italian National Research Center on Aging (IRCCS INRCA), 87100 Cosenza, Italy
Interests: pharmacoepidemiology; biostatistics; geriatric syndromes; multimorbidity; frailty; chronic kidney disease
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Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD) is a growing concern in older populations, where the interplay of aging-related physiological changes, multimorbidity, and medication complexities presents unique challenges. CKD in older adults often goes undiagnosed or undertreated due to atypical presentations and limitations in conventional diagnostic approaches. Furthermore, the coexistence of multiple chronic conditions in this demographic leads to polypharmacy, increasing the risk of drug–drug interactions, adverse drug events, and medication nonadherence. The decline in renal function also significantly impacts pharmacokinetics and pharmacodynamics, necessitating careful adjustment of dosages and drug regimens to ensure safety and efficacy. This Special Issue seeks to delve into the intersection of CKD and pharmacoepidemiology in older individuals, emphasizing the challenges, therapeutic advancements, and insights gained from real-world data. Contributions will address areas such as the optimization of pharmacotherapy, the development of personalized medicine strategies, and the integration of innovative therapies tailored for this vulnerable group. By bringing together original research, systematic reviews, and expert perspectives, this issue aims to provide a comprehensive resource for clinicians, researchers, and policymakers to enhance care and improve outcomes for older adults living with CKD.

Dr. Luca Soraci
Guest Editor

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Keywords

  • chronic kidney disease (CKD)
  • pharmacoepidemiology
  • older adults
  • polypharmacy
  • multimorbidity
  • therapeutic advances
  • potentially inappropriate medications

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Published Papers (1 paper)

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Research

11 pages, 697 KiB  
Article
Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients
by Guido Gembillo, Luca Soraci, Luigi Peritore, Rossella Siligato, Vincenzo Labbozzetta, Alfio Edoardo Giuffrida, Felicia Cuzzola, Claudia Spinella, Adolfo Romeo, Vincenzo Calabrese, Alberto Montesanto, Andrea Corsonello and Domenico Santoro
Geriatrics 2025, 10(2), 33; https://doi.org/10.3390/geriatrics10020033 - 24 Feb 2025
Viewed by 647
Abstract
Background/Objectives: Hemodialysis (HD) patients with advanced chronic kidney disease (CKD) are highly vulnerable to complications from SARS-CoV-2 infection. Anemia management in this population is complex, particularly due to erythropoietin resistance, which may be exacerbated by COVID-19-related inflammation. To this aim, in this small-scale [...] Read more.
Background/Objectives: Hemodialysis (HD) patients with advanced chronic kidney disease (CKD) are highly vulnerable to complications from SARS-CoV-2 infection. Anemia management in this population is complex, particularly due to erythropoietin resistance, which may be exacerbated by COVID-19-related inflammation. To this aim, in this small-scale retrospective study, we investigated trends in the erythropoietin resistance index (ERI) over time in patients with and without SARS-CoV-2 infection. Methods: This single-center retrospective study included 25 HD patients, divided into two groups: 15 with a history of SARS-CoV-2 infection (CoV2 group) and 10 without (nonCoV2 group). The ERI was assessed over four visits, with 70–100-day intervals between them. Linear mixed models were used to evaluate factors associated with ERI changes. Results: Patients in the CoV2 group exhibited significantly higher ERI increases between T1 (baseline) and T2 (post-infection) compared to the nonCoV2 group (median ΔERI: +4.65 vs. −0.27, p < 0.001). During the T2–T4 recovery period, CoV2 patients demonstrated a delayed but substantial decline in the ERI, converging to baseline levels by T4. Male sex and hemoglobin levels were negatively associated with the ERI. Conclusions: SARS-CoV-2 infection induces transient but significant erythropoietin resistance in HD patients, likely due to inflammation and disrupted erythropoiesis. Tailored anemia management strategies, including the potential use of hypoxia-inducible factor stabilizers, are warranted. Larger, multicenter studies are needed to validate these findings and improve treatment protocols. Full article
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