multivariable survey-weighted Cox and Fine & Gray competing risk models, we examined how MHR relates to death from any cause and kidney-specific mortality.We validated our findings through LASSO regression and Boruta algorithm feature selection.Results: Over 82 months of follow-up, we documented all-cause and renal mortality rates of 72.25 (95%CI: 69.03-75.46)and 1.6 (1.11-2.09)per 1,000 person-years.The findings were striking: elevated MHR independently predicted 31% higher all-cause mortality risk (HR 1.31, 95%CI 1.19-1.44)and 33% higher kidney-specific mortality risk (sdHR 1.33, 95%CI 1.02-1.73),even after adjusting for eGFR, ACR, and key clinical factors.Feature selection confirmed MHR ranks among the top predictors of renal death, alongside eGFR and ACR.Conclusion: MHR emerges as a powerful, independent mortality predictor in older CKD patients, offering prognostic value beyond traditional kidney markers.Because it requires no special testing, just routine bloodwork, MHR represents a practical, cost-effective tool for sharpening risk assessment in aging populations with kidney disease.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.
Tam et al. (Wed,) studied this question.