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Estimation of glomerular filtration rate: does haemoglobin discriminate between ageing and true CKD?
Nephrol Dial Transplant. 2009 Jun; 24(6):1828-33.ND

Abstract

AIM

The aim of this study was to analyse the association between chronic kidney disease (CKD) defined by an estimated glomerular filtration rate (eGFR) <60 ml/min/ 1.73 m(2) and anaemia in older people.

BACKGROUND

Guidelines focus on early identification and management of CKD to prevent CKD progression and cardiovascular disease. However, the significance of CKD classification using eGFR in older people is unclear.

METHODS

Serum creatinine and haemoglobin from individuals attending non-nephrology outpatient clinics were extracted from the state pathology provider over a 4-month period. The associations between eGFR, gender, age and haemoglobin were explored.

RESULTS

Serum creatinine in 9853 individual patients aged > or =15 years was available for analysis. Haemoglobin was simultaneously available in 8752 (88.8%) subjects. There was a negative relationship between age and median eGFR, and the slope of the regression line was -0.68 ml/min/year for males and -0.74 ml/min/year for females. Over 35% of individuals > or =65 years were classified as having CKD stage > or =3. Odds ratios for haemoglobin <100 g/l for an eGFR <15, 15-29 and 30-59 versus reference GFR > or =60 ml/ min/1.73 m(2) in subjects 25-44 years were 34.2 (30.7-37.7), 23.4 (20.2-26.6) and 7.2 (5.3-9.1), respectively. In comparison, these were 8.9 (6.7-11.1), 5.6 (4.9-7.3) and 1.6 (1.1-2.1), respectively, in subjects > or =65 years. In subjects > or =65 years, odds ratios for haemoglobin <100 g/l for an eGFR 30-44 and 45-59 ml/min/1.73 m(2) versus reference GFR > or =60 ml/min/1.73 m(2) were 1.9 (1.3-2.5) and 1.2 (0.7-1.7), respectively.

CONCLUSIONS

An eGFR <60 ml/min/1.73 m(2) is very common in older people. Only an eGFR <45 ml/min/1.73 m(2) identified a smaller sub-group of older people with an increased prevalence of significant anaemia suggesting a clinically relevant disease. The benefits of identifying older people with an eGFR > or =45 ml/min/1.73 m(2) need to be determined.

Authors+Show Affiliations

Department of Nephrology, Fremantle Hospital, Western Australia, Australia. paolo.ferrari@health.wa.gov.auNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19131346

Citation

Ferrari, Paolo, et al. "Estimation of Glomerular Filtration Rate: Does Haemoglobin Discriminate Between Ageing and True CKD?" Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 24, no. 6, 2009, pp. 1828-33.
Ferrari P, Xiao J, Ukich A, et al. Estimation of glomerular filtration rate: does haemoglobin discriminate between ageing and true CKD? Nephrol Dial Transplant. 2009;24(6):1828-33.
Ferrari, P., Xiao, J., Ukich, A., & Irish, A. (2009). Estimation of glomerular filtration rate: does haemoglobin discriminate between ageing and true CKD? Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 24(6), 1828-33. https://doi.org/10.1093/ndt/gfn738
Ferrari P, et al. Estimation of Glomerular Filtration Rate: Does Haemoglobin Discriminate Between Ageing and True CKD. Nephrol Dial Transplant. 2009;24(6):1828-33. PubMed PMID: 19131346.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estimation of glomerular filtration rate: does haemoglobin discriminate between ageing and true CKD? AU - Ferrari,Paolo, AU - Xiao,Jianguo, AU - Ukich,Alf, AU - Irish,Ashley, Y1 - 2009/01/08/ PY - 2009/1/10/entrez PY - 2009/1/10/pubmed PY - 2009/8/26/medline SP - 1828 EP - 33 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 24 IS - 6 N2 - AIM: The aim of this study was to analyse the association between chronic kidney disease (CKD) defined by an estimated glomerular filtration rate (eGFR) <60 ml/min/ 1.73 m(2) and anaemia in older people. BACKGROUND: Guidelines focus on early identification and management of CKD to prevent CKD progression and cardiovascular disease. However, the significance of CKD classification using eGFR in older people is unclear. METHODS: Serum creatinine and haemoglobin from individuals attending non-nephrology outpatient clinics were extracted from the state pathology provider over a 4-month period. The associations between eGFR, gender, age and haemoglobin were explored. RESULTS: Serum creatinine in 9853 individual patients aged > or =15 years was available for analysis. Haemoglobin was simultaneously available in 8752 (88.8%) subjects. There was a negative relationship between age and median eGFR, and the slope of the regression line was -0.68 ml/min/year for males and -0.74 ml/min/year for females. Over 35% of individuals > or =65 years were classified as having CKD stage > or =3. Odds ratios for haemoglobin <100 g/l for an eGFR <15, 15-29 and 30-59 versus reference GFR > or =60 ml/ min/1.73 m(2) in subjects 25-44 years were 34.2 (30.7-37.7), 23.4 (20.2-26.6) and 7.2 (5.3-9.1), respectively. In comparison, these were 8.9 (6.7-11.1), 5.6 (4.9-7.3) and 1.6 (1.1-2.1), respectively, in subjects > or =65 years. In subjects > or =65 years, odds ratios for haemoglobin <100 g/l for an eGFR 30-44 and 45-59 ml/min/1.73 m(2) versus reference GFR > or =60 ml/min/1.73 m(2) were 1.9 (1.3-2.5) and 1.2 (0.7-1.7), respectively. CONCLUSIONS: An eGFR <60 ml/min/1.73 m(2) is very common in older people. Only an eGFR <45 ml/min/1.73 m(2) identified a smaller sub-group of older people with an increased prevalence of significant anaemia suggesting a clinically relevant disease. The benefits of identifying older people with an eGFR > or =45 ml/min/1.73 m(2) need to be determined. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/19131346/Estimation_of_glomerular_filtration_rate:_does_haemoglobin_discriminate_between_ageing_and_true_CKD L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfn738 DB - PRIME DP - Unbound Medicine ER -