Analysis of heterogeneity in kidney function decline in the aged population / 中华老年医学杂志

ABSTRACT

Objective To study the rate of kidney function decline and the influencing factors in the aged population. Methods This was a prospective population-based study of 468 participants aged 65 years and older. All participants’ general health information and serum creatinine levels were collected as the baseline. After a 3-year follow-up ,the serum creatinine level of each participant was measured again.Kidney function was assessed with estimated glomerular filtration rate (eGFR) calculated using the Chronic Kidney Disease-Epidemiology Collaboration ( CKD-EPI ) equation. Outcomes of interest were mean eGFR decline and rapid decline in eGFR (annual eGFR loss≥3 ml·min－1·1.73 m －2).Risk factors were analyzed with Logistic regression. Results At baseline ,the mean age of participants was(78.4 ± 8.7)years and the mean eGFR was(74.8 ± 14.5)ml ·min－1·1.73 m －2.Annual eGFR decline was 1.5 ml·min－1·1.73 m －2,with rapid declines in 149 (32%) participants and stable kidney function in 319 (68%) individuals. The rate of kidney function loss slowed down as the age increased.Baseline eGFR was an independent predictor for rapid kidney function decline. The incidence of rapid kidney function decline in individuals with eGFR ≥ 60 ml· min－1·1.73 m －2was 2.40 times (95% CI1.16-4.98) higher than that of participants with eGFR＜60 ml·min－1·1.73 m －2after adjustment for confounders. Conclusions Kidney function changes in the community-dwelling elderly in China are heterogeneous. Most elderly individuals do not show appreciable kidney function decline over a 3-year period.