Chronic kidney disease progression in aged patients

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.