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Chronic kidney disease in octogenarians.
Shani Shastri1, Hocine Tighiouart, Ronit Katz
1Tufts Medical Center, Boston, MA 02111, USA.
Summary
Chronic kidney disease (CKD) is highly prevalent in octogenarians, with varying prevalence based on the estimating equation used. CKD showed a significant association with cardiovascular disease (CVD) in this elderly population.
Area of Science:
- Nephrology
- Geriatrics
- Cardiology
Background:
- Limited data exist on chronic kidney disease (CKD) prevalence and clinical significance in the very elderly.
- Octogenarians represent a unique demographic for studying age-related health conditions.
Purpose of the Study:
- To determine the prevalence of CKD in octogenarians.
- To investigate the association between prevalent CKD and cardiovascular disease (CVD) in this age group.
Main Methods:
- Cross-sectional analysis of 1028 participants from the Cardiovascular Health Study All Stars.
- CKD defined as estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m(2).
- GFR estimated using CKD-Epi creatinine and cystatin C equations (eGFR(EPI), eGFR(CYS3var), eGFR(CYS1var)).
- Prevalent CVD defined as a composite of coronary heart disease, heart failure, and stroke.
Main Results:
- Mean age was 86 years; 39% had prevalent CVD.
- CKD prevalence varied by equation: 51% (eGFR(EPI)), 46% (eGFR(CYS3var)), and 33% (eGFR(CYS1var)).
- CKD was associated with CVD, with odds ratios ranging from 1.53 to 2.09 depending on the equation used.
Conclusions:
- Reduced eGFR is highly prevalent in octogenarians.
- The eGFR(CYS1var) equation showed the strongest association between CKD and CVD, despite the lowest CKD prevalence.
- Estimates of kidney function in the elderly should be interpreted cautiously due to the lack of validated equations.
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