Risk profile in chronic kidney disease stage 3: older versus younger patients

Area of Science:

• Nephrology
• Geriatrics
• Primary Care Research

Background:

• Chronic kidney disease (CKD) prevalence rises with age, but its impact in older adults is often underestimated.
• Elderly individuals (≥75 years) are frequently excluded from clinical research, limiting understanding of their specific health risks.
• CKD stage 3 is common in primary care, necessitating a comparison of risk profiles between older and younger patient groups.

Purpose of the Study:

• To compare the risk profile of older (≥75 years) versus younger patients with stage 3 chronic kidney disease (CKD) in a primary care setting.

Main Methods:

• Prospective study involving 1,741 participants with an estimated glomerular filtration rate (eGFR) between 59-30 ml/min/1.73 m(2) across 32 primary care practices.
• Data collection included medical history, demographics, clinical assessment, and urine and serum biochemistry.
• Comparison of risk profiles between subjects aged ≥75 years and younger participants.

Main Results:

• Older subjects (≥75 years) exhibited a significantly lower mean eGFR compared to younger counterparts.
• The elderly group presented a higher risk profile, characterized by increased albuminuria, arterial stiffness, and elevated serum uric acid levels.
• The study included 1,741 participants, with a mean age of 72.9 years, 60% female, 98% white, and 17% diabetic.

Conclusions:

• Stage 3 CKD in older adults is associated with a more significant risk profile for CKD progression and cardiovascular events than in younger patients.
• CKD should not be considered a benign condition in all elderly patients.
• Further research is needed to identify elderly individuals with CKD at highest risk who could benefit from targeted interventions.