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Comparative Study
. 2009 Jan;24(1):86-92.
doi: 10.1007/s11606-008-0850-3. Epub 2008 Nov 6.

High prevalence of stage 3 chronic kidney disease in older adults despite normal serum creatinine

O Kenrik Duru  1 , Roberto B Vargas, Dulcie Kermah, Allen R Nissenson, Keith C Norris
Affiliations
Comparative Study

High prevalence of stage 3 chronic kidney disease in older adults despite normal serum creatinine

O Kenrik Duru et al. J Gen Intern Med. 2009 Jan.

Abstract

Background: Serum creatinine is commonly used to diagnose chronic kidney disease (CKD), but may underestimate CKD in older adults when compared with using glomerular filtration rates (eGFR). The magnitude of this underestimation is not clearly defined.

Objective: Using the Modification of Diet in Renal Disease (MDRD) equation, to describe both the prevalence and the magnitude of underestimation of stage 3 CKD (GFR 30-59 ml/min/1.73 m(2)), as well as ideal serum creatinine cutoff values to diagnose stage 3 CKD among Americans > or =65 years of age.

Design: Cross-sectional.

Participants: A total of 3,406 participants > or =65 years of age from the 1999-2004 National Health and Nutrition Examination Surveys (NHANES).

Measurements: Serum creatinine levels were used to determine eGFR from the MDRD equation. Information on clinical conditions was self-reported.

Results: Overall, 36.1% of older adults in the US have stage 3 or greater CKD as defined by eGFR values. Among older adults with stage 3 CKD, 80.6% had creatinine values < or =1.5 mg/dl, and 38.6% had creatinine values < or =1.2 mg/dl. Optimal cutoff values for serum creatinine in the diagnosis of stage 3 CKD in older adults were > or =1.3 mg/dl for men and > or =1.0 mg/dl for women, regardless of the presence or absence of hypertension, diabetes, or congestive heart failure.

Conclusion: Use of serum creatinine underestimates the presence of advanced (stage 3 or greater) CKD among older adults in the US. Automated eGFR reporting may improve the accuracy of risk stratification for older adults with CKD.

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References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0002-9343(97)00150-2', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0002-9343(97)00150-2'}, {'type': 'PubMed', 'value': '9375704', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/9375704/'}]}
    2. McCullough P, Wolyn R, Rocher LL, et al. Acute renal failure after coronary intervention: Incidence, risk factors, and relationship to mortality. Am J Med. 1997;103:368–375. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '9454527', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/9454527/'}]}
    2. Mangano CM, Diamondstone LS, Ramsay JG, et al. Renal dysfunction after myocardial revascularization: Risk factors, adverse outcomes, and hospital resource utilization. The Multicenter Study of Postoperative Ischemia Group. Ann Intern Med. 1998;128:194–203. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '16461961', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/16461961/'}]}
    2. Rahman M, Pressel S, Davis BR, et al. Cardiovascular outcomes in high-risk hypertensive patients stratified by baseline glomerular filtration rate. Ann Intern Med. 2006;144:172–180. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1056/NEJMoa041365', 'is_inner': False, 'url': 'https://doi.org/10.1056/nejmoa041365'}, {'type': 'PubMed', 'value': '15385655', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15385655/'}]}
    2. Anavekar NS, McMurray JJ, Velazquez EJ, et al. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N Engl J Med. 2004;351:1285–1295. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.jacc.2005.11.084', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.jacc.2005.11.084'}, {'type': 'PubMed', 'value': '16697315', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/16697315/'}]}
    2. Smith GL, Lichtman JH, Bracken MB, et al. Renal impairment and outcomes in heart failure: systematic review and meta-analysis. J Am Coll Cardiol. 2006;47:1987–1996. - PubMed

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