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Rate of kidney function decline in older adults: a comparison using creatinine and cystatin C.
Tuesday,2012-11-06 12:10 America/Los_Angeles — eenright
| Title | Rate of kidney function decline in older adults: a comparison using creatinine and cystatin C. |
| Publication Type | Journal Article |
| Year of Publication | 2009 |
| Authors | Shlipak, MG, Katz, R, Kestenbaum, B, Fried, LF, Newman, AB, Siscovick, DS, Stevens, L, Sarnak, MJ |
| Journal | Am J Nephrol |
| Volume | 30 |
| Issue | 3 |
| Pagination | 171-8 |
| Date Published | 2009 |
| ISSN | 1421-9670 |
| Keywords | Age Factors, Aged, Creatinine, Cystatin C, Disease Progression, Female, Glomerular Filtration Rate, Humans, Kidney, Kidney Diseases, Male, Risk Factors |
| Abstract | <p><b>BACKGROUND/AIMS: </b>The aim of this study was to determine the decline in the estimated glomerular filtration rate (eGFR) in elderly persons and to compare estimates based on creatinine and cystatin C.</p><p><b>METHODS: </b>In the Cardiovascular Health Study, GFR changes in an elderly cohort were estimated from serum creatinine and cystatin C measured at baseline, year 3 and year 7 in 4,380 participants (age 72 +/- 5 years at entry). Outcomes were mean eGFR decline, incident chronic kidney disease (CKD) and rapid decline in eGFR (annual loss >3 ml/min/1.73 m(2)).</p><p><b>RESULTS: </b>Mean annual eGFR loss as estimated from creatinine was 0.4 +/- 3.6 ml/min/1.73 m(2), with 16% of the participants experiencing a rapid decline. Mean eGFR loss as estimated from cystatin C was 1.8 +/- 2.6, with 25% of the participants experiencing a rapid decline (p < 0.001 for both). Among participants without baseline CKD, incident CKD was detected at year 7 in 10% (n = 263) using creatinine and 19% (n = 544) using cystatin C (p < 0.001). Increasing age was the strongest predictor of rapid decline; adjusted odds ratios were 1.38 (1.16-1.65), 1.62 (1.31-1.99) and 2.96 (2.28-3.84) for participants aged 70-74, 75-79 and 80+ at baseline, compared with those aged 65-69.</p><p><b>CONCLUSION: </b>In elderly persons, cystatin C estimated substantially larger declines in kidney function than creatinine did. Defining the optimal measurement of kidney function in elderly persons should be a high priority for future research.</p> |
| DOI | 10.1159/000212381 |
| Alternate Journal | Am J Nephrol |
| PubMed ID | 19349699 |
| PubMed Central ID | PMC2820322 |
| Grant List | K24DK078204-01 / DK / NIDDK NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States R01AG02700 / AG / NIA NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States R01 HL073208-01 / HL / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States |