[Epidemiology of chronic renal failure in the elderly]

The prevalence of chronic renal failure (CRF) increases, particularly in the elderly. According to countries, 7% to 55% of the population over the age of 60 is presenting with CRF. In France, the incidence per year of end stage renal disease (ESRD) is 400 pmp over the age of 65 years, with regional fluctuations. The incidence rate of ESRD in patients with chronic kidney disease (CKD) decreases with age and is 2 to 3 folds higher in the 20-60 year age group than in the 61-74 year age group. Among patients presenting with CKD, the counts of patients developing ESRD diminishes with age; it is 2 to 3 fold lower in 61-74 years old patients than in 20-60 years old. This is due to an increased cardiac and vascular morbidity and to increasing mortality associated to CRF. For the elderly it is estimated that 18 to 20% patients-year presenting with CKD die before entering ESRD. In 30 to 50% patients-year a cardiovascular disease occurs. Diabetic and hypertensive nephropathies are responsible for 48% to 73% of ESRD cases in patients older than 65, according to countries and regions; on the other hand, glomerular diseases account for only 10% of cases. Moreover, in Europe, between 1990 and 1999, the incidence of ESRD due to diabetic, hypertensive and vascular diseases increased for more than 10% per year in the elderly. CRF is a serious condition in the elderly particularly owing to the fact that cardiac and vascular morbidity is high as well as mortality. The risk of evolution towards ESRD is also increased in the elderly.