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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Relationship between renal function and functional decline: role of the estimating equation
Claudio Pedone1, Andrea Corsonello, Stefania Bandinelli
1Area di Geriatria, Università Campus Biomedico, Roma, Italy. c.pedone@unicampus.it
Journal of the American Medical Directors Association
|April 1, 2011
Summary
Reduced kidney function, estimated by formulas like Cockcroft-Gault, predicts worsening disability in older adults. This highlights the importance of monitoring renal function to identify at-risk individuals.
Area of Science:
- Gerontology
- Nephrology
- Epidemiology
Background:
- Glomerular filtration rate (GFR) estimation formulas are used clinically.
- Decreased GFR is linked to poorer health outcomes.
- This study investigates if GFR estimation predicts worsening disability in the elderly.
Purpose of the Study:
- To evaluate if Modification of Diet in Renal Disease (MDRD) formulas predict worsening disability better than Cockcroft-Gault or measured creatinine clearance.
- To assess the association between estimated GFR and new-onset disability in older adults.
Main Methods:
- Analysis of 666 participants from the InCHIANTI study with 6-year follow-up.
- Evaluation of measured creatinine clearance and GFR estimated by MDRD and Cockcroft-Gault formulas.
- Prediction of new disability, defined as loss of at least one activity of daily living (ADL).
Main Results:
- A significant association was found between declining GFR and increased risk of worsening disability (Mantel-Haenszel P < .001).
- The risk of disability was notably higher for GFR < 60 mL/min/m², with relative risks ranging from 3.19 to 4.40 depending on the formula used.
- After adjusting for confounders, these risk estimates were reduced.
Conclusions:
- Renal function estimation using Cockcroft-Gault or MDRD formulas can identify elderly individuals at higher risk of disability.
- Further research is needed to understand the mechanisms linking reduced kidney function to disability.
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