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Classification of chronic kidney disease in the elderly: pitfalls and errors
Christopher G Winearls1, Richard J Glassock
1Oxford Kidney Unit, The Churchill Hospital, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK. chris.winearls@orh.nhs.uk
Nephron. Clinical Practice
|August 12, 2011
Summary
A lower glomerular filtration rate (GFR) in older adults is often due to aging, not necessarily disease. Stable low GFR may pose risks like acute kidney injury but isn't always chronic kidney disease.
Area of Science:
- Nephrology
- Geriatrics
- Internal Medicine
Background:
- Glomerular filtration rate (GFR) naturally declines with age.
- This decline can be exacerbated by vascular conditions.
- Current diagnostic criteria may overestimate kidney disease in the elderly.
Purpose of the Study:
- To clarify the significance of a lower GFR in the elderly.
- To differentiate physiological aging from pathological kidney disease.
- To identify potential risks associated with a stable low GFR in older individuals.
Main Methods:
- Review of existing literature on GFR and aging.
- Analysis of diagnostic criteria for chronic kidney disease in elderly populations.
- Evaluation of the clinical implications of reduced GFR in older adults.
Main Results:
- A stable, physiologically sufficient low GFR in the elderly is not typically indicative of disease.
- The prevalence of significant kidney disease in older adults may be overestimated.
- A low GFR can be a risk factor for acute kidney injury, medication errors, and cardiovascular issues.
Conclusions:
- Physiological decline in GFR due to aging should not be automatically equated with chronic kidney disease.
- Careful assessment is needed to distinguish normal aging from pathological conditions.
- Monitoring low GFR in the elderly is important due to associated health risks.
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