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. 2010 May 4;152(9):561-7.
doi: 10.7326/0003-4819-152-9-201005040-00006.

The association between age and nephrosclerosis on renal biopsy among healthy adults

Andrew D Rule  1 , Hatem Amer, Lynn D Cornell, Sandra J Taler, Fernando G Cosio, Walter K Kremers, Stephen C Textor, Mark D Stegall
Affiliations

The association between age and nephrosclerosis on renal biopsy among healthy adults

Andrew D Rule et al. Ann Intern Med. .

Abstract

Background: Chronic kidney disease is common with older age and is characterized on renal biopsy by global glomerulosclerosis, tubular atrophy, interstitial fibrosis, and arteriosclerosis.

Objective: To see whether the prevalence of these histologic abnormalities in the kidney increases with age in healthy adults and whether histologic findings are explained by age-related differences in kidney function or chronic kidney disease risk factors.

Design: Cross-sectional study.

Setting: Mayo Clinic, Rochester, Minnesota, from 1999 to 2009.

Patients: 1203 adult living kidney donors.

Measurements: Core-needle biopsy of the renal cortex obtained during surgical implantation of the kidney, and medical record data of kidney function and risk factors obtained before donation.

Results: The prevalence of nephrosclerosis (> or =2 chronic histologic abnormalities) was 2.7% (95% CI, 1.1% to 6.7%) for patients aged 18 to 29 years, 16% (CI, 12% to 20%) for patients aged 30 to 39 years, 28% (CI, 24% to 32%) for patients aged 40 to 49 years, 44% (CI, 38% to 50%) for patients aged 50 to 59 years, 58% (CI, 47% to 67%) for patients aged 60 to 69 years, and 73% (CI, 43% to 90%) for patients aged 70 to 77 years. Adjustment for kidney function and risk factor covariates did not explain the age-related increase in the prevalence of nephrosclerosis.

Limitation: Kidney donors are selected for health and lack the spectrum or severity of renal pathologic findings in the general population.

Conclusion: Kidney function and chronic kidney disease risk factors do not explain the strong association between age and nephrosclerosis in healthy adults.

Primary funding source: National Institutes of Health, U.S. Public Health Service.

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Figures

Figure 1
Figure 1
The relationship between glomerular filtration rate (GFR) and age in persons with nephrosclerosis (red x) and in persons without nephrosclerosis (blue o). Regression of glomerular filtration rate onto age in persons with nephrosclerosis (red line) is similar to persons without nephrosclerosis (blue line). Dashed curves represent the 95% confidence interval.
See this image and copyright information in PMC

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