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Chronic kidney disease progression in aged patients

Murat Tuğcu1, Dilek Barutçu Ataş2

  • 1Marmara University Pendik Training and Research Hospital, Fevzi Çakmak District, Muhsin Yazıcıoğlu Street No:10 Pendik, 34899, Istanbul, Turkey. drmrttgc@hotmail.com.

International Urology and Nephrology
|March 7, 2021
PubMed

Insights

Chronic kidney disease (CKD) progresses slowly in older adults. High initial creatinine and proteinuria indicate progression, while cardiac issues may accelerate the decline towards end-stage renal disease (ESRD).

Area of Science:

  • Nephrology
  • Geriatrics
  • Internal Medicine

Background:

  • Chronic kidney disease (CKD) is a significant health concern, with prevalence increasing in aging populations.
  • The prognosis of CKD in elderly patients presents unique characteristics compared to younger individuals.
  • Understanding CKD progression in the elderly is crucial for effective management.

Purpose of the Study:

  • To investigate the progression patterns of CKD in patients aged 80 years and older.
  • To identify factors associated with CKD progression and the development of end-stage renal disease (ESRD) in this demographic.
  • To clarify the specific characteristics of CKD in aged patients.

Main Methods:

  • A retrospective study involving 334 elderly patients (≥80 years) diagnosed with stage 3-4 CKD.
  • CKD progression was measured by the annual decline in estimated glomerular filtration rate (eGFR).
  • Comorbidities were assessed using the Charlson comorbidity index (CCI), with specific attention to diabetes, hypertension, and cardiac conditions. Patients were categorized based on progression to ESRD.

Main Results:

  • Over half of the patients (57.2%) showed CKD progression, with a median annual eGFR decline of 0.8 ml/min/1.73 m².
  • Only 8.1% of patients progressed to ESRD.
  • Progression to ESRD was significantly linked to cardiac comorbidities, proteinuria, and baseline eGFR levels.

Conclusions:

  • CKD progression in aged patients is generally slow.
  • Elevated initial creatinine levels and proteinuria are key indicators of potential CKD progression in the elderly.
  • Cardiac comorbidities appear to be a significant factor in the advancement of CKD towards ESRD in older adults.
Abstract

Keywords:
Chronic kidney diseaseElderlyFactorsProgression

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