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Determinants of the Evolution of Kidney Function With Age
Anna C van der Burgh1,2, Dimitris Rizopoulos3, M Arfan Ikram2
1Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Kidney International Reports
|December 13, 2021
Summary
Kidney function declines with age. Modifiable factors like smoking and high blood pressure accelerate this decline, particularly in men and smokers.
Area of Science:
- Nephrology
- Gerontology
- Epidemiology
Background:
- Kidney function naturally declines with aging.
- Determinants of this decline in the general population require further investigation.
Purpose of the Study:
- To investigate the rate and determinants of kidney function decline in a large, population-based cohort.
- To analyze the evolution of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (ACR) with age.
Main Methods:
- Utilized joint models to analyze longitudinal eGFR and ACR data from 12,062 participants.
- Stratified analysis for 8 potential determinants including cardiovascular risk factors and disease.
Main Results:
- Annual eGFR decline was 0.82 ml/min/1.73 m² and ACR increased by 0.05 mg/g.
- Prediabetes and higher BMI detrimentally affected ACR but not eGFR.
- Men, smokers, and individuals with diabetes exhibited faster eGFR decline.
Conclusions:
- Identified prediabetes, smoking, and blood pressure as modifiable risk factors for kidney function decline.
- Hyperfiltration may contribute to accelerated decline in men and smokers, similar to diabetes.
- Adjusting for age and sex is crucial for accurate chronic kidney disease diagnosis in aging populations.
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