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Epidemiology and Public Health Concerns of CKD in Older Adults

Enrica Fung1, Manjula Kurella Tamura1

  • 1Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA; and VA Palo Alto Geriatric Research and Education Clinical Center, Palo Alto, CA.

Advances in Chronic Kidney Disease
|December 29, 2015
PubMed

Insights

Chronic kidney disease (CKD) is common in older adults, but estimating kidney function is difficult due to sarcopenia and competing mortality risks. Comprehensive management requires considering comorbidities and geriatric syndromes, with further research needed.

Area of Science:

  • Geriatrics
  • Nephrology
  • Internal Medicine

Background:

  • Chronic kidney disease (CKD) prevalence increases with age.
  • Estimating glomerular filtration rate (GFR) in older adults is complex.
  • Sarcopenia and competing risks (e.g., mortality) impact GFR estimation and CKD progression.

Purpose of the Study:

  • To highlight the challenges in managing CKD in the elderly population.
  • To emphasize the need for tailored approaches considering specific geriatric factors.
  • To identify areas for future research in geriatric nephrology.

Main Methods:

  • Review of existing literature on CKD in older adults.
  • Analysis of factors affecting GFR estimation in this demographic.
  • Consideration of comorbidities and geriatric syndromes in CKD management.

Main Results:

  • Sarcopenia significantly affects the accuracy of standard GFR formulae.
  • Mortality risk is a critical competing risk influencing CKD progression to end-stage kidney disease.
  • Geriatric syndromes and comorbidities necessitate a holistic assessment approach.

Conclusions:

  • CKD management in older adults requires specialized approaches beyond standard protocols.
  • Accurate GFR estimation is challenging and requires consideration of muscle mass.
  • Integrated care addressing comorbidities and geriatric syndromes is crucial for this population.

Keywords:
CKDOlder adultsPublic health

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