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Chronic kidney disease: who is affected, who is at risk and who cares?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Mayer, Gert |
| Copyright Year | 2014 |
| Abstract | In this issue of the journal, Chudek et al. report the results from the PolSenior study, which was conducted cross sectionally in the years from 2007–11 aiming to assess the health and socioeconomic status of the elderly (>65 years) in Poland. In total, 3793 subjects provided blood and urine samples as well as information on their medical history and completed a questionnaire. Creatinine was measured by Jaffe reaction and estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula; urinary albumin excretion was quantified by the albumin/creatinine ratio (ACR). Of the participants, 29.7% had a reduced eGFR (defined as a value <60 mL/min/ 1.73 m), 12.5% had an ACR >30 mg/g creatinine and 36.5% were diagnosed with chronic kidney disease (CKD) according to the National Kidney Foundation (NKF) Kidney Disease Outcomes Quality Initiative (K/DOQI) definition (18.6% Stages I and II, 15.7% had reduced eGFR and elevated albuminuria, 65.7% of subjects with CKD had a decreased eGFR only). The prevalence of a decreased eGFR, albuminuria and CKD for the entire Polish elderly population was estimated to be 21.2, 12.3 and 29.4%, respectively [1]. The K/DOQI guidelines suggested using at least the values of eGFR and proteinuria/albuminuria to determine the stages of chronic renal disease. In Europe, several general population-based studies are available holding this information (see Table 1). Even though no study directly focused on the elderly, all provided at least some information about the effect of age on the prevalence of CKD (Table 2). In Groningen/Netherlands, all 85 421 inhabitants aged 28–75 years were invited to participate in the ‘Prevention of Renal and Vascular End stage Disease (PREVEND)’ prospective study. In total, 40 856 responded and a cohort was selected enriched for the presence of high albuminuria. The final study population consisted of 6000 out of the 7768 individuals with a urinary albumin excretion >10 mg/L and 2592 out of 3395 with albuminuria below this threshold. After excluding subjects with missing data, 8506 participants were analysed. In total, 6905 subjects had no renal disease (81.2%), 2.9% had CKD Stage I, 10% Stage II and 5.8% Stage III; 8 and 3 patients, respectively, were in Stages IV and V. The mean age of the population was 49 years and there was a strong association between increasing age and CKD class (the group without CKD had a mean age of 47.4 years, the one with Stage I 48.2 years, Stage II 56.5 years and Stage III patients were 63.2 years old on average) [2]. When extrapolating the prevalence data to the general population in the Netherlands the numbers changed slightly (1.3, 3.8 and 5.3% for Stages I, II and III, respectively, a total of 10.4%) [3]. In Norway, 70.4% of 92 939 individuals invited participated in a large-scale general health survey (second Health Survey of North Trondelag, HUNT II). The mean age of the population was 49 years. Whereas serum creatinine was determined in all participants, urinary albumin excretion was measured only in a 5% random sample. The prevalence of CKD Stages I–IV was 3.1, 3.4, 4.6 and 0.16%, respectively (total 11.3%) and thus comparable to the results obtained in Groningen. When looking at [Modification of Diet in Renal Disease (MDRD) formula derived] eGFR values only, there was a strong association between age and loss of renal function. As an example, 0.2% of the participants between 20 and 39 years had an eGFR between 30 and 59 mL/min/1.73 m when compared with 18% in those older than 70 years [4]. Otero et al. published the results of a cross-sectional study performed in Spain. In total, 13 013 individuals stratified by age, sex and residence were targeted, 6464 were contacted and 2746 completed a questionnaire. The mean age was 50 years and the prevalence of CKD Stages I–IV was 0.99, 1.3, 6.5 and 0.27%, respectively. Again, a strong trend was observed with |
| File Format | PDF HTM / HTML |
| DOI | 10.1093/ndt/gft475 |
| PubMed reference number | 24286972 |
| Journal | Medline |
| Volume Number | 29 |
| Issue Number | 5 |
| Alternate Webpage(s) | https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/ndt/29/5/10.1093_ndt_gft475/3/gft475.pdf?Expires=1492846164&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q&Signature=R-Ev550BrNtFqwYpxZ-oLPF0oefUEBkHiwjzabX6FWSgU5YNUva6pBzMf53h6DLwstjx7NMNmDpLULCvgT7k1HDFxSoHG9BnnEJXhab93qDZwb4C5TI~r5tpyzQCPKf6IGjyjXQcav7~unYD3U6EVHRonZgXmPveEponyZphcx~8rRDpNrtIBSNBCyu3BeS9lu9mCNf7M9KN96dPt9SwiHn~KtSuUys2hL6FuAGi5E5HL3FgrRcuOWnTc0htV5PCMWrQbR9-La0k~0~ZuOYhVcmbf8Z2Me55Hfi4cCEf1vZbNtzxEnnDFMSskncg9iH0keb8UnGrjL6lFy9ABI1Pmw__ |
| Alternate Webpage(s) | https://watermark.silverchair.com/gft475.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAjwwggI4BgkqhkiG9w0BBwagggIpMIICJQIBADCCAh4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM7shE124moI9M3adZAgEQgIIB7wDJwWjRHrdfGUIMT7p1QKVCj8X_sfV_bI4SEfrRf8iANwrZpo1mKHCbo2aal-gVFqahrk0o4GsUhbc6fXWnd_3O4bMPAH-xnzQyRSd-TtBvgj6t4-xVtKTQtKnsydIpxLd_tSoKVqWkB_ulrb6F60Sx6inQ1vfayhU0GZDCP-Xpdnq4laHtwUIHvifR12Y3EuICM12DczGftl-vhCqaiGKtsiAvm-uUE6YqVOPQsxl5nca0FnI4BfcvFfJfaH4gxtxaY868F3Cu8oLOfZCb73YOPwqsyIm3PHmexa0prZVX5Hp05NclBrXZanpvisgnNZXvjOn2xqs2ZZD-dsekk_cVCs0lCwNWg-eQr_pxzAYwX0ZpkRRaCDkJu0uPDJVBDrXwXVmac1SdEv1dAPStS1NKW5224ZVmsEQ0f8i887NtZDFKLT_ACo9wPftqDIZClvHqZzZNgOa5lPahn4jSkKNon3ZQ-l03CcngY80HK5KOEUke4WIhF-3tCmWeg8PA6yDtSBjtsAitW3Se-I1XSMVYG-CW6X2KKDKX2rlCGTvrOnK8zeZftUuY-WgoB8GnEKjYkTh8xe3ObPf6r6RapTw96hBk0tAPpJcONVCZlR3H3wM0RUhJi8OZpDeHsD6hgMjdw6JWZ2k1FFYsp67uzQ |
| Alternate Webpage(s) | https://doi.org/10.1093/ndt%2Fgft475 |
| Journal | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
