Loss of renal function in the elderly Italians: a physiologic or pathologic process?

Area of Science:

• Nephrology
• Geriatrics
• Epidemiology

Background:

• Chronic kidney disease (CKD) is increasingly prevalent, particularly among the elderly.
• Understanding CKD progression across different age groups is crucial for effective management.

Purpose of the Study:

• To assess and compare the progression of chronic kidney disease (CKD) in patients of varying age groups.
• To investigate the relationship between age and the rate of CKD progression.

Main Methods:

• A retrospective observational study included 116 adult patients with CKD (eGFR <60mL/min/1.73 m(2)) and a follow-up of at least 5 years.
• Patients were stratified into four age groups: 25-55, 56-65, 66-75, and 76-87 years.
• Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epidemiology Collaboration and Modification of Diet in Renal Disease formulas.

Main Results:

• Younger patients exhibited longer follow-up periods and fewer comorbidities compared to older groups.
• While all groups showed a decline in renal function, the rate of progression was slower in older age groups.
• Patients aged 76-87 years had the minimal difference between baseline and end-of-follow-up eGFR, indicating slower CKD progression.

Conclusions:

• CKD progression is significantly slower in elderly Italian patients compared to younger individuals.
• The findings suggest that a substantial proportion of elderly CKD patients may not progress to end-stage renal disease.
• This has implications for anticipating the burden of CKD and the need for renal replacement therapy in aging populations.