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. 2012 Feb;60(2):310-5.
doi: 10.1111/j.1532-5415.2011.03818.x. Epub 2012 Jan 27.

Metabolic complications in elderly adults with chronic kidney disease

Paul E Drawz  1 , Denise C Babineau, Mahboob Rahman
Affiliations

Metabolic complications in elderly adults with chronic kidney disease

Paul E Drawz et al. J Am Geriatr Soc. 2012 Feb.

Abstract

Objectives: To determine whether elderly adults with a low glomerular filtration rate (GFR) are at risk for anemia, hyperkalemia, acidosis, and hyperphosphatemia.

Design: Retrospective study.

Setting: Veterans Affairs Medical Center.

Participants: Thirteen thousand eight hundred seventy-four veterans aged 65 and older with chronic kidney disease (CKD) and a GFR between 15 and 60 mL/min per 1.73 m(2) . Their average age was 79.

Measurements: Anemia was defined as a hemoglobin level of less than 10 g/dL, hyperkalemia as a potassium level greater than 5.5 mEq/L, acidosis as a bicarbonate level of less than 21 mEq/L, and hyperphosphatemia as a phosphorus level greater than 4.6 mg/dL. Multivariable logistic regression was used to evaluate whether age modifies the effect of low GFR on metabolic complications by including an interaction term between age and GFR in each model.

Results: The average GFR of participants was 46.5 mL/min per 1.73 m(2) , 3.1% had anemia, 2.5% hyperkalemia, 2.3% acidosis, and 4.4% had hyperphosphatemia. Lower GFR was associated with higher rates of metabolic complications across all age groups (odds ratio per 5-mL/min per 1.73 m(2) decrease in GFR in multivariable models was 1.21 for anemia, 1.26 for hyperkalemia, 1.45 for acidosis, and 1.72 for hyperphosphatemia). There was no significant interaction between age and GFR in models including only age and GFR or in multivariable models (P-values for age by GFR interaction term: 0.66 for anemia, 0.19 for hyperkalemia, 0.54 for acidosis, and 0.22 for hyperphosphatemia).

Conclusion: Elderly adults with CKD are at risk for anemia, hyperkalemia, acidosis, and hyperphosphatemia; age does not modify the relationship between GFR and development of metabolic complications. Elderly adults with low GFR should be monitored for metabolic complications, regardless of age.

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Conflict of interest statement

Conflicts of interest: Drs Drawz and Rahman report receiving grant support from NIH. Dr Babineau report no conflicts of interest.

Figures

Figure 1
Figure 1. CONSORT Diagram
Abbreviations: GFR, glomerular filtration rate.
Figure 2
Figure 2. Metabolic complications by age and GFR category (%)
Abbreviations: GFR, glomerular filtration rate.
See this image and copyright information in PMC

Comment in

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