Cardiovascular outcomes and death are major consequences of chronic kidney disease (CKD) occurring in the moderate and severe stages of the disease, prior to advancement into dialysis and transplantation. At all levels of kidney function, mortality increases with age; however, the risk of mortality decreases with age within CKD groups. Moreover, the relative risk of cardiovascular outcomes seems to be lower in older individuals. Clinical prognosis seems to vary by age, but age has not been adequately investigated as a prognostic indicator in these patients; previous studies have focused on the relationship between kidney function and outcomes. The purpose of the study was to examine the relationship between age and cardiovascular event-free survival in patients with moderate and severe CKD. This study was a secondary analysis of a cohort (aged 45–84 years) in the Multi-Ethnic Study of Atherosclerosis. The selected sample (n=762) exhibited a 15≤estimated glomerular filtration rate (eGFR)\u3c60 ml/min/1.73m2 and was followed up for over 6 years. Kaplan Meier analysis and Cox proportional hazards regressions were performed to elaborate on the role of age on time to first event of combined outcome (cardiovascular events and mortality) and non-fatal cardiovascular events. Additionally, nonlinearity of the age and outcome relationship, and the interaction effect of age and eGFR were examined. Age had a highly significant predictive role on time to combined outcome and cardiovascular events in individuals with moderate (stage 3) and severe (stage 4) CKD. Importantly, however, the effect of age on outcomes dissipated in a subsample with eGFR values below 45 ml/min/1.73m2 (stages 3b and 4), with no significant differences noted in the risk of outcomes between younger and older individuals. This study elucidated the significant moderator role of eGFR on the relationship between age and outcome in CKD patients. These findings suggest a need for the consideration of age-specific approaches in the care of patients with moderate and severe CKD. Younger adults with CKD require routine examinations and early preventive measures for the reduction of cardiovascular morbidity and mortality. In older adults, therapeutic efforts may need to be directed at comorbidities rather than a focus on eGFR-related consequences
