aspirin. In some centres biopsy is performed by nephrologists and in others by radiologists Results: In total, 6979 biopsies in 5755 patients were recorded between 2014 and 2021 (5095 native biopsies and 1884 transplant biopsies), with an adequacy for diagnosis of 98.1%. Table 1 describes the demographics, indications, operator and diagnoses made by biopsy type. Overall, in patients undergoing native kidney biopsy 2.4% sufered a major complication and 1.4% of patients undergoing transplant biopsy. The commonest complication was the requirement for arteriography, with or without embolisation. We included CT angiography in this group. There were 8 deaths within 28 days attributable to renal biopsy. Conclusion: Kidney biopsy remains safe for the vast majority of patients and complications are less likely with transplant biopsy. #5817 EPIDEMIOLOGY OF CHRONIC KIDNEY DISEASE AND COMORBID ILLNESS IN OLDER HOSPITALIZED PATIENTS Andra Nastasa 1 , Gheorghe Mahu 2 , Mihai Onofriescu 1 ,3 , Mugurel Apetrii 1,3 , Hani Hussien 1 , Ioana Dana Alexa 1 ,4 , Adrian Covic 1 ,5 and Ionut Nistor 3 ,6 1 “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania, 2 “Grigore T. Popa” University of Medicine and Pharmacy, Project Center for Innovation and Technological Transfer MAVIS, Iasi, Romania, 3 “Dr. C.I. Parhon” Clinical Hospital, Iasi, Romania, 4 “Dr. C.I. Parhon” Clinical Hospital, Head of Geriatrics Department, Iasi, Romania, 5 “Dr. C.I. Parhon” Clinical Hospital, Head of Nephrology and Transplantation Department, Iasi, Romania and 6 “Grigore T. Popa” University of Medicine and Pharmacy, Methodological Center for Medical Research and Evidence-Based Medicine, Iasi, Romania Background and Aims: The number of older people in Europe is expanding. Although chronic kidney disease (CKD) becomes more common with increas- ing age, data concerning epidemiology of CKD in older people are scarce, especially in Eastern Europe countries. These patients have multiple chronic conditions that must be correctly quantifed for guiding risk stratifcation and subsequent management. Previously, European Renal Best Practice (ERBP) guidelines shed some light on managing older patients with advanced CKD, by stimulating the implementation of validated tools for predicting the most critical risks (death and progression to end-stage renal disease). Risk stratifcation can further inform decisions about the intensity of care (dialysis versus conservative treatment). In the current analysis, we aimed to fll the gap in CKD epidemiology in older people from Romania by describing a large population of hospitalized geriatric patients. Method: In this retrospective cohort study, we included all patients aged ≥ 65 years hospitalized in the Geriatric Department of “Dr. C. I. Parhon” Hospital from Iași, Romania, between 2012 – 2022. This Geriatric Unit covers the entire North-East region of the country, so patients are representative of a population of almost 4 million people. CKD was identifed as decreased estimated glomerular fltration rate (<60 ml/min/1.73 m 2 ) according to CKD-EPI equation. We investigated comorbid conditions including diabetes mellitus, hypertension/hypertensive heart disease, coronary artery disease, congestive heart failure, atrial fbrillation, chronic respiratory failure and anemia. Results: 3563 geriatric patients (59,2% females) were hospitalized between 2012–2022, totalling 5124 hospital admissions. The most common diagnosis was congestive heart failure (1958 cases, 38,2%) frequently due to hypertensive heart disease (877 patients, 44.8% of CHF cases). 3116 patients (87,4% of the total population) had a serum creatinine assay. Among these patients, the prevalence of CKD using the CKD-EPI equation was 32%. The mean age of CKD patients was 79 years, gender distribution was unequal (63,4% females) and almost half of them (49,1%) had stage 3a CKD. The most frequent comorbidities in patients with CKD were congestive heart failure (33%), diabetes (19%) and hypertension (17%), followed by atrial fbrillation (11%), chronic respiratory failure (9%), coronary artery disease (6%) and anemia (3%). The distribution of CKD patients stratifed by the number of comorbidities showed that 86,7% had ≥ 2 comorbidities. The largest CKD subgroup was the one that associated three comorbidities (315 patients, 31.5%), followed by two subgroups that had two comorbidities (249 patients, 24,9%), respectively four comorbidities (189 patients, 18.9%). Only a minority of CKD patients (24 adults, 2,4%) had no other chronic condition. Conclusion: With the ageing of the population, cardiovascular disease is becoming more common. In our population of geriatric patients, heart failure was the leading cause of hospitalization and the most frequent comorbid condition in CKD patients. One in three adults ≥ 65 years had CKD, a fnding similar to other literature data. We emphasized that in older adults, CKD is not an isolated entity, which makes caring for these patients challenging, especially if we add the negative impact of other superimposed geriatric syndromes like frailty and cognitive decline. #2620 WHY DIALYSIS PATIENTS CHOOSE OR REFUSE KIDNEY TRANSPLANTATION AS RENAL REPLACEMENT THERAPY: A QUALITATIVE STUDY Shkelqim Muharremi 1 , Aleksandar Poposki 1 , Vangjelka Kovacheska Shavreska 1 , Goce Spasovski 2 and Gjulsen Selim 2 1 Specialized hospital of Nephrology, Nephrology, Struga, Republic of North Macedonia and 2 University Clinic of Nephrology, Nephrology and transplantation, Skopje, Republic of North Macedonia Background and Aims: Kidney transplantation is considered the best renal replacement therapy (RRT) for patients with end-stage renal disease, nevertheless, some dialysis patients refuse to be transplanted. Many patients are concerned about their quality of life as a patient on dialysis compared to life with a new, functioning kidney. The results from many studies have shown that patients who have been living with a transplanted kidney for 10 years demonstrate a greater likelihood of still being alive than those on dialysis. For every 10 patients receiving a new kidney, eight will still have that kidney working three years after the operation. So, considering survival alone, individuals receiving a new kidney do better than those on dialysis. But not all the CKD and CKD on HD share the same opinion and a number refuse kidney transplantation. The aim of this paper is to identify the reasons for choosing or refusing kidney transplantation as renal replacement therapy among patient with Chronic Kidney Disease (CKD). Method: We used purposeful sampling because it was more relevant to identify and to select the individuals who seemed in-keeping with the social facts we wanted to study. We wanted to retrace participants’ paths of care to identify the reasons for their choice. Patients who were treated using hemodialysis as well as those who opted for peritoneal dialysis were interviewed. We also interviewed health professionals (doctors, nurses, a psychologist) for their opinions on the nature of their relationship with patients in the decision making process regarding kidney transplantation. Results: Data were collected through interviews with CKD patient and CKD patient treated by dialysis. Health professionals, medical doctors and nurses were also interviewed. A thematic analysis was used to analyze the data. The collected data showed that various reasons account for CKD patients’ refusal replacement therapy without positive outcome, refusal to have an allograft. There are also situations such as the lack of organ, the age factor, contraindications to kidney transplantation that not allow some CKD patients to have a kidney transplant. Among the patients who choose kidney transplantation, lots of them have lack of information about transplantation process others see kidney transplantation as a cure which will fnally make them machine dependent and a small group see it as a normal process. Conclusion: This paper shows that the choice of kidney transplantation depends on patients’ perceptions of its outcomes. Some circumstances, such as the lack of an available organ or specifc medical criteria including age factor and malignancy, reduce CKD patients’ participation in the decision-making process. REFERENCES 1. E. Morales et al. Preemptive kidney transplantation in elderly recipients with kidneys discarded of very old donors: a good alternative. Nefrologia (2015). 2. S.S. Farah et al. Barriers to kidney transplantation as a choice of renal replacement therapy. Transplant Proc (2018). 3. E.J. Gordon. They don’t have to sufer for me”: why dialysis patients refuse ofers of living donor kidneys. Med Anthropol Q (2001). #3619 CKD EPI 2021 EQUATION FOR EGFR HAS GOOD EFFICACY TO PREDICT CLINICAL OUTCOMES IN A LARGE PROSPECTIVE COHORT OF ADULT KOREANS Ho Jun Chin 1,2 and Ki Young Na 1 ,2 1 Seoul National University College of Medicine, Seoul, Korea, Rep. of South Korea and 2 Seoul National University Bundang Hospital, Seongnam-si, Korea, Rep. of South Korea Background and Aims: A new eGFR equation using serum creatinine (CKD-EPI 2021) without race were developed by Chronic Kidney Disease Abstracts i569 Downloaded from https://academic.oup.com/ndt/article/38/Supplement_1/gfad063c_2620/7195362 by guest on 15 June 2023