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The evolution of renal function and the incidence of end-stage renal disease in patients aged ≥ 50 years.
Nephrol Dial Transplant. 2012 Jun; 27(6):2297-303.ND

Abstract

BACKGROUND

The prevalence of chronic kidney disease (CKD) is high, especially among older patients.

METHODS

In order to identify risk factors for the evolution towards end-stage renal disease (ESRD), a cohort of patients ≥ 50 years of age for whom at least four serum creatinine measurements were available were selected from a primary care-based database. The slope of changes in estimated glomerular filtration rate (eGFR) (using the Modification of Diet in Renal Disease formula) was calculated, and ESRD was defined as eGFR <15 mL/min. Risk factors for ESRD were analysed using Cox regression analysis.

RESULTS

The cohort included 24,682 patients (13,305 women) with a mean age at first available measurement of 64 years. During follow-up (average 7.8 years), 212 patients (0.9%) developed ESRD. The incidence of ESRD per 10,000 person-years is low and depends on baseline eGFR (Stages 0-2: 3, Stage 3A: 13, Stage 3B: 121 and Stage 4: 765). Adjusted hazard ratios (HRs) for patients with baseline eGFR in Stage 3B or 4 depended on age (HR = 0.47 or 0.41 for patients 65-79 years and HR = 0.26 or 0.32 for patients ≥ 80 years compared with patients aged 50-64 years). Females (HR = 1.48) and patients with diabetes (HR = 1.20), hypertension (HR = 1.25), high total cholesterol (HR = 1.28) or high low-density lipoprotein (LDL) cholesterol (HR = 1.39) were at higher risk for ESRD.

CONCLUSIONS

Baseline eGFR, diabetes, high cholesterol, high LDL, hypertension and female gender are independent risk factors for developing ESRD. Older age at baseline predicts a lower risk.

Authors+Show Affiliations

Department of General Practice, Katholieke Universiteit Leuven, Leuven, Belgium. gijs.vanpottelbergh@med.kuleuven.beNo 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

22102615

Citation

Van Pottelbergh, Gijs, et al. "The Evolution of Renal Function and the Incidence of End-stage Renal Disease in Patients Aged ≥ 50 Years." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 27, no. 6, 2012, pp. 2297-303.
Van Pottelbergh G, Bartholomeeusen S, Buntinx F, et al. The evolution of renal function and the incidence of end-stage renal disease in patients aged ≥ 50 years. Nephrol Dial Transplant. 2012;27(6):2297-303.
Van Pottelbergh, G., Bartholomeeusen, S., Buntinx, F., & Degryse, J. (2012). The evolution of renal function and the incidence of end-stage renal disease in patients aged ≥ 50 years. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 27(6), 2297-303. https://doi.org/10.1093/ndt/gfr659
Van Pottelbergh G, et al. The Evolution of Renal Function and the Incidence of End-stage Renal Disease in Patients Aged ≥ 50 Years. Nephrol Dial Transplant. 2012;27(6):2297-303. PubMed PMID: 22102615.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The evolution of renal function and the incidence of end-stage renal disease in patients aged ≥ 50 years. AU - Van Pottelbergh,Gijs, AU - Bartholomeeusen,Stephaan, AU - Buntinx,Frank, AU - Degryse,Jan, Y1 - 2011/11/18/ PY - 2011/11/22/entrez PY - 2011/11/22/pubmed PY - 2012/10/4/medline SP - 2297 EP - 303 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 27 IS - 6 N2 - BACKGROUND: The prevalence of chronic kidney disease (CKD) is high, especially among older patients. METHODS: In order to identify risk factors for the evolution towards end-stage renal disease (ESRD), a cohort of patients ≥ 50 years of age for whom at least four serum creatinine measurements were available were selected from a primary care-based database. The slope of changes in estimated glomerular filtration rate (eGFR) (using the Modification of Diet in Renal Disease formula) was calculated, and ESRD was defined as eGFR <15 mL/min. Risk factors for ESRD were analysed using Cox regression analysis. RESULTS: The cohort included 24,682 patients (13,305 women) with a mean age at first available measurement of 64 years. During follow-up (average 7.8 years), 212 patients (0.9%) developed ESRD. The incidence of ESRD per 10,000 person-years is low and depends on baseline eGFR (Stages 0-2: 3, Stage 3A: 13, Stage 3B: 121 and Stage 4: 765). Adjusted hazard ratios (HRs) for patients with baseline eGFR in Stage 3B or 4 depended on age (HR = 0.47 or 0.41 for patients 65-79 years and HR = 0.26 or 0.32 for patients ≥ 80 years compared with patients aged 50-64 years). Females (HR = 1.48) and patients with diabetes (HR = 1.20), hypertension (HR = 1.25), high total cholesterol (HR = 1.28) or high low-density lipoprotein (LDL) cholesterol (HR = 1.39) were at higher risk for ESRD. CONCLUSIONS: Baseline eGFR, diabetes, high cholesterol, high LDL, hypertension and female gender are independent risk factors for developing ESRD. Older age at baseline predicts a lower risk. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/22102615/The_evolution_of_renal_function_and_the_incidence_of_end_stage_renal_disease_in_patients_aged_≥_50_years_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfr659 DB - PRIME DP - Unbound Medicine ER -