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Still, its significance in patients with fragility fractures remains unclear, as does the clinical relevance of only mild-to-moderate CKD (GFR of 45\u201359\u00a0ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ) in older adults in general. We investigated how different eGFR categories (&lt;\u200945, 45\u201359, and\u2009\u2265\u200960\u00a0ml\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      ) are associated with mortality and functional outcomes in orthogeriatric patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 453 consecutive patients admitted to an orthogeriatric unit from 2015 to 2023. Estimated glomerular filtration rate (eGFR) at admission was categorized into\u2009&lt;\u200945, 45\u201359, and\u2009\u2265\u200960\u00a0ml\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      . Outcomes included mortality (via Kaplan\u2013Meier curves, regression, and ROC analysis), in-hospital complications, and functional recovery. Mediation by frailty was also analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients had a mean age of 82.9\u2009\u00b1\u20096.8\u00a0years; 74.8% were female. CKD was prevalent: 52.4% had eGFR\u2009&lt;\u200960, and 33.6% had eGFR\u2009&lt;\u200945\u00a0ml\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      . Those with eGFR\u2009&lt;\u200945\u00a0ml\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      had worse baseline functional status, more comorbidities, and poorer recovery. The 45\u201359 group showed similar or better outcomes than those with eGFR\u2009\u2265\u200960\u00a0ml\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      , including mortality. Long-term all-cause mortality was significantly higher in the\u2009&lt;\u200945\u00a0ml\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      group (HR 1.77, 95% CI 1.25\u20132.51), but not in the 45\u201359\u00a0ml\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      group (HR 1.01, 95% CI 0.64\u20131.58).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In orthogeriatric patients, an eGFR\u2009&lt;\u200945\u00a0ml\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      identifies individuals at higher risk of poor outcomes. However, eGFR 45\u201359 is not associated with adverse prognosis and may not warrant classification as CKD in this context. A lower diagnostic threshold may better reflect clinical realities in this population.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s41999-025-01286-w","type":"journal-article","created":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:28:52Z","timestamp":1755451732000},"page":"2221-2233","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic kidney disease and mortality in fragility fracture patients: revisiting GFR thresholds"],"prefix":"10.1007","volume":"16","author":[{"given":"Joany","family":"Mari\u00f1o","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Strittmatter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maik","family":"Gollasch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Frank","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4873-5519","authenticated-orcid":false,"given":"Maximilian","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,17]]},"reference":[{"issue":"7","key":"1286_CR1","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1681\/ASN.2005101085","volume":"17","author":"M Tonelli","year":"2006","unstructured":"Tonelli M et al (2006) Chronic kidney disease and mortality risk: a systematic review. 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