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Chronic Kidney Disease and Pharmacoepidemiology in Older Individuals: Challenges, Insights,...
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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 December 2025 | Viewed by 1887

Special Issue Editor

Dr. Luca Soraci

E-Mail Website
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
Special Issues, Collections and Topics in MDPI journals

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

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

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Published Papers (2 papers)

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Research

9 pages, 224 KB  
Article
Clinical Inertia in SGLT2 Inhibitor Use Among Elderly Patients with Type 2 Diabetes and Chronic Kidney Disease: A Comparison of Regional and University Hospital Practice
by Kyriaki Vafeidou, Ourania Psoma, Evangelos Apostolidis, Anastasia Sarvani, Michael Doumas, Kalliopi Kotsa, Vasileios Tsimihodimos and Theocharis Koufakis
Geriatrics 2025, 10(6), 144; https://doi.org/10.3390/geriatrics10060144 - 6 Nov 2025
Abstract
Background/Objectives: Type 2 diabetes (T2D) and chronic kidney disease (CKD) frequently coexist in older adults. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) are recommended for renal and heart protection, yet their use in routine care remains inconsistent. We aimed to investigate differences in SGLT2i prescribing between [...] Read more.
Background/Objectives: Type 2 diabetes (T2D) and chronic kidney disease (CKD) frequently coexist in older adults. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) are recommended for renal and heart protection, yet their use in routine care remains inconsistent. We aimed to investigate differences in SGLT2i prescribing between regional and university hospital settings and assess whether such disparities persist after accounting for patient characteristics. Methods: In this retrospective analysis, patients were stratified by follow-up site (regional vs. university hospital). The primary outcome was SGLT2i use. Logistic regression models were adjusted for strong determinants of prescribing decisions, including age, sex, hypertension, dyslipidemia, heart failure, and estimated glomerular filtration rate. We tested the robustness of the results using additional analyses, including exclusion of frail patients and adjustment with propensity score methods, such as matching and inverse probability weighting (IPTW). Results: The study included 135 patients, of whom 80 were followed at the regional hospital and 55 at the university hospital. SGLT2i use was significantly lower in the regional setting (27.5% vs. 63.6%, p < 0.001). In adjusted models, university follow-up remained strongly associated with SGLT2i prescription [odds ratio 3.60, 95% confidence interval (CI) 1.61–8.03, p = 0.0018]. IPTW demonstrated 4.40-fold higher odds of SGLT2i use in the university hospital setting (95% CI 2.07–9.36, p < 0.001). Conclusions: These findings indicate that the lower use of SGLT2i among older adults with T2D and CKD followed in regional hospitals may reflect patterns consistent with clinical inertia, underscoring the importance of efforts to promote equitable and guideline-aligned prescribing practices across levels of care. Full article
(This article belongs to the Special Issue Chronic Kidney Disease and Pharmacoepidemiology in Older Individuals: Challenges, Insights, and Therapeutic Advances)
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11 pages, 697 KB  
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
Cited by 3 | Viewed by 1340
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
(This article belongs to the Special Issue Chronic Kidney Disease and Pharmacoepidemiology in Older Individuals: Challenges, Insights, and Therapeutic Advances)
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