(C-044) Accelerated Biological Aging and Postoperative Adverse Renal Events: A Multicenter Cohort Study

Tuesday, August 26, 2025

12:00 PM - 1:30 PM ET

Presenting Author(s)

XY

Xuan Yin

School of International Business, China Pharmaceutical University, Jiangsu, China, China (People's Republic)

Co-Author(s)

LC

Lihai Chen

Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China, China (People's Republic)
CZ

Chen Zhang

Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China, China (People's Republic)
SK

Siyu Kong

School of International Business, China Pharmaceutical University, Jiangsu, China, China (People's Republic)
Xinchi Li

China Pharmaraceutical University, China (People's Republic)
XB

Xinyi Bu

Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China, China (People's Republic)
KD

Ke Ding

Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China, China (People's Republic)
FY

Fan Yang

School of International Business, China Pharmaceutical University, Jiangsu, China, China (People's Republic)
DC

Dan Cheng

Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China, China (People's Republic)
HS

Hongwei Shi

Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China, China (People's Republic)
XL

Xuesheng Liu

Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei, China, China (People's Republic)
jz

jifang zhou

China Pharmaceutical University, China (People's Republic)

Background: Previous studies indicate that biological age correlates more closely with clinical outcomes compared to chronological age. However, the association between accelerated biological aging and postoperative adverse renal events remains unclear.

Objectives: To investigate the relationship between accelerated biological aging and postoperative adverse renal events in a large multicenter surgical cohort.

Methods: We conducted a retrospective cohort study (2015–2023) at three academic medical centers, including patients undergoing surgery with complete anesthetic records. Biological age was estimated using the Phenotypic Age and Klemera-Doubal method biological age (KDM-BA). Biological age acceleration was calculated as the residual from a linear regression model of biological age against chronological age. The primary endpoint was acute kidney injury (AKI) within 7 days postoperatively. Secondary endpoints included AKI stage 2 or 3 (AKI 2+), acute kidney disease (AKD), and length of stay (LOS). Hazard ratios (HR) were adjusted for relevant confounders.

Results: Among 92,217 patients (median age 62 [52-71] years, 44.1% female), 57.9% exhibited biological aging acceleration. The incidence of AKI was 1.63 per 100 person-days. After adjustment, biological aging was significantly associated with AKI (adjusted HR [aHR] 1.87, 95% confidence interval [CI] 1.84-1.90; aHR 1.81, 95% CI 1.78-1.85), AKI 2+ (aHR 2.69, 95% CI 2.63-2.75; aHR 2.62, 95% CI 2.55-2.68), and AKD (aHR 1.76, 95% CI 1.69-1.83; aHR 1.77, 95% CI 1.69-1.86) in PhenoAge acceleration and KDM-BA acceleration, respectively. Dose-response analyses demonstrated a strong monotonic positive association between biological age acceleration and postoperative renal disease risk.

Conclusions: Our findings highlight the association between accelerated biological aging and increased risk of postoperative adverse renal events. Further prospective studies are needed to validate these findings across diverse populations.