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Moderate renal insufficiency at 70 years predicts mortality
Y Maaravi1, M Bursztyn, R Hammerman-Rozenberg
1Department of Rehabilitation and Geriatric Medicine, Hadassah University Hospital, Mount Scopus, PO Box 24035, Jerusalem 91240, Israel. maaravi@md2.huji.ac.il
QJM : Monthly Journal of the Association of Physicians
|January 13, 2006
Summary
In elderly individuals, a reduced estimated glomerular filtration rate (eGFR) is a significant predictor of mortality. Many older adults with impaired kidney function have normal serum creatinine levels, highlighting the need for better assessment tools.
Area of Science:
- Gerontology
- Nephrology
- Epidemiology
Background:
- Kidney function, measured by glomerular filtration rate (GFR), declines with age.
- Serum creatinine is an insensitive marker for kidney function in the elderly.
- Predictive GFR formulas are underutilized in this population.
Purpose of the Study:
- To investigate the association between a low predicted GFR and mortality risk in older adults.
- To assess the predictive value of renal insufficiency for mortality in the elderly.
Main Methods:
- A longitudinal cohort study of 445 community-dwelling 70-year-olds was conducted.
- Kidney function was assessed using the Cockcroft-Gault (CG) and MDRD equations to predict GFR.
- Moderate renal insufficiency was defined as a predicted GFR <60 ml/min.
Main Results:
- 46% of participants had a predicted GFR <60 ml/min, with normal serum creatinine in most.
- Twelve-year mortality was higher in those with reduced GFR (38.7%) compared to others (27%).
- Lower predicted GFR was a significant independent predictor of mortality (HR 2.108, p=0.0002).
Conclusions:
- Moderate renal insufficiency, identified by predicted GFR, is a strong independent predictor of mortality in community-dwelling elderly.
- This finding is particularly relevant as many at-risk individuals present with normal serum creatinine.
- Utilizing GFR prediction equations is crucial for identifying at-risk elderly individuals.
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