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Chronic kidney disease in older people; disease or dilemma?

Aimun K Ahmed1, Siobhan H M Brown, Ahmed H Abdelhafiz

  • 1Department of Renal Medicine, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|September 4, 2010
PubMed

Insights

Most elderly patients with chronic kidney disease (CKD) face poor outcomes from cardiovascular disease, not end-stage renal disease. Prioritizing cardiovascular prevention is crucial for this population.

Area of Science:

  • Geriatrics
  • Nephrology
  • Cardiology

Background:

  • Chronic kidney disease (CKD) disproportionately affects the elderly.
  • CKD in older adults is associated with significant cardiovascular, cognitive, and disability risks.
  • Most elderly CKD patients do not progress to end-stage renal disease (ESRD).

Purpose of the Study:

  • To review issues specific to older individuals with CKD.
  • To identify high-risk subgroups of elderly CKD patients.
  • To guide intensive cardiovascular risk reduction interventions and identify clinically relevant renal disease.

Main Methods:

  • Review of literature and clinical data pertaining to elderly CKD patients.
  • Analysis of outcomes, focusing on cardiovascular events versus progression to ESRD.
  • Identification of factors associated with increased risk.

Main Results:

  • The majority of elderly CKD patients are at higher risk for cardiovascular mortality than ESRD.
  • Cardiovascular disease prevention should be the primary focus for most elderly CKD patients.
  • Specific subgroups of older adults with CKD can be identified for targeted interventions.

Conclusions:

  • Management strategies for elderly CKD patients should prioritize cardiovascular health.
  • Nephrologist assessment is beneficial only for a minority likely to progress to ESRD.
  • Risk stratification is essential for effective cardiovascular risk reduction in older adults with CKD.

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