Article

Natural history of older adults with impaired kidney function: the InCHIANTI study.

Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
Rejuvenation Research (impact factor: 3.83). 09/2011; 14(5):513-23. DOI:10.1089/rej.2011.1179 pp.513-23
Source: PubMed

ABSTRACT The aim of this study was to assess the kidney function of an older community-dwelling population at baseline and appraise its evolution after 3 years of follow-up in terms of chronic kidney disease (CKD) stage progression, magnitude of glomerular filtration rate (GFR) changes, and value of serum creatinine. This was a prospective population-based study of 676 Italian participants, aged 65 years and older. GFR was estimated using the Cockcroft-Gault equation and the Modification of Diet in Renal Disease Study equation. Using the Cockcroft-Gault equation. A total of 33% of participants had criteria of CKD (GFR < 60 mL/min) at baseline; among them, the majority remained stable, 10% improved, and 7% progressed to more severe CKD stages at follow-up. Loss of GFR in participants with GFR < 60 mL/min was significantly lower (1.4 mL/min per year) than in participants with GFR ≥ 60 mL/min (3.3 mL/min per year) at baseline. Most participants classified with CKD stage 2 (GFR 60-89 mL/min) or stage 3 (GFR 30-59 mL/min) at baseline did not change stage, whereas 55% of people with CKD stage 1 (GFR > 90 mL/min) at baseline worsened to stage 2 and 10% worsened to stage 3. An abnormal high level of serum creatinine at baseline did not help to predict who might worsen at follow-up. Older people with CKD displayed a low progression of renal disease and therefore are at higher risk for co-morbidities related to CKD than for progression to end-stage renal disease.

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Keywords

3 years
 
676 Italian participants
 
7% progressed
 
chronic kidney disease
 
CKD stage 1
 
CKD stage 2
 
Cockcroft-Gault equation
 
end-stage renal disease
 
glomerular filtration rate
 
higher risk
 
kidney function
 
low progression
 
older community-dwelling population
 
Older people
 
prospective population-based study
 
renal disease
 
Renal Disease Study equation
 
severe CKD stages
 
stage 2
 
stage 3