Chronic Kidney Disease in Octogenarians

Shani Shastri, Hocine Tighiouart, Ronit Katz, Dena E. Rifkin, Linda F. Fried, Michael G. Shlipak, Anne B. Newman, Mark J. Sarnak

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28 Scopus citations

Abstract

Background and objectives There are limited data on the prevalence of chronic kidney disease (CKD) and its clinical importance in the very old. We examined the prevalence of CKD in octogenarians and its association with cardiovascular disease (CVD). Design, setting, participants, & measurements In a cross-sectional analysis of 1028 participants from the Cardiovascular Health Study All Stars, we evaluated association of prevalent CKD with CVD using multivariable logistic regression. CKD was defined as eGFR of <60 ml/min per 1.73 m2. GFR was estimated using CKD-Epi creatinine and cystatin C equations that incorporate coefficients for age, gender, and race (eGFREPI, eGFRCYS3var) and the one-variable cystatin C equation (eGFRCYS1var). Prevalent CVD was defined as a composite of coronary heart disease, heart failure, and stroke. Results Mean age was 86 years, 64% were women, 86% were Caucasians, 14% had diabetes, and 39% had prevalent CVD. Mean eGFREPI, eGFRCYS3var, and eGFRCYS1var were 59, 62, and 70 ml/min per 1.73 m2, and 51%, 46%, and 33% had CKD, respectively. Associations of CKD with CVD varied by equation in adjusted analyses: CKDEPI (OR, 1.53; 95% CI, 1.15 to 2.03), CKDCYS3var (OR, 1.67; 95% CI, 1.25, 2.23), and CKDCYS1var (OR, 2.09; 95% CI, 1.55, 2.83). Conclusions Reduced eGFR is highly prevalent in octogenarians, and the eGFRCYS1var equation yielded the lowest prevalence of CKD but the strongest association with prevalent CVD. Because there are no validated estimating equations in the elderly, estimation of kidney function on the basis of on any one equation should be interpreted with caution.

Original languageEnglish (US)
Pages (from-to)1410-1417
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume6
Issue number6
DOIs
StatePublished - Jun 1 2011

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ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Shastri, S., Tighiouart, H., Katz, R., Rifkin, D. E., Fried, L. F., Shlipak, M. G., Newman, A. B., & Sarnak, M. J. (2011). Chronic Kidney Disease in Octogenarians. Clinical Journal of the American Society of Nephrology, 6(6), 1410-1417. https://doi.org/10.2215/CJN.08801010