Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 May 10:12:343.
doi: 10.1186/1471-2458-12-343.

Prevalence and determinants of chronic kidney disease in community-dwelling elderly by various estimating equations

Dietrich Rothenbacher  1 , Jochen Klenk, Michael Denkinger, Mahir Karakas, Thorsten Nikolaus, Richard Peter, Wolfgang Koenig; ActiFE Study Group
Affiliations

Prevalence and determinants of chronic kidney disease in community-dwelling elderly by various estimating equations

Dietrich Rothenbacher et al. BMC Public Health. .

Abstract

Background: Chronic kidney disease (CKD) represents a global public health problem. Few data exist in the elderly. The objective of the current study is to estimate the prevalence of CKD by means of various established and new equations and to identify the main determinants of CKD in elderly.

Methods: The ActiFE Ulm (Activity and Function in the Elderly in Ulm) study is a population-based cohort study in people of 65 years and older. Kidney function was assessed by means of estimated glomerular filtration rate (eGFR) based on two creatinine- (Cr-; MDRD, CKD-EPI) and one cystatin C - (CysC-) based method. The relationship between various potential risk factors and CKD was quantified using unconditional logistic regression.

Results: A total of 1471 subjects were in the final analysis (mean age 75.6 years, SD 6.56). Overall, prevalence of CKD (eGFR < 60 mL/min/1.73 m(2)) was 34.3% by MDRD, 33.0% by CKD-EPI, and 14.6% by the CysC-based eGFR. All eGFRs showed statistically significant correlations with C-reactive protein, uric acid, as well as with lipid values. In multivariable analysis age was clearly related to prevalence of CKD and the risks were highest with the CysC-based equation. Females had a higher risk for CKD stages 3-5 with MDRD (OR 1.63; 95% CI: 1.23-2.16) whereas the OR was 1.23 (95% CI 0.92-1.65) with the CKD-Epi and OR = 0.89 (95% CI 0.58-1.34) with the CysC-based equation after multivariable adjustment. Although the cystatin C based definition of CKD resulted in a lower prevalence compared to the creatinine based ones, other measures of renal damage such as albuminuria were more prevalent in those defined by CysC-eGFR.

Conclusions: Prevalence of CKD is very variable based on the used estimating equation. More work is needed to evaluate the various estimating equations especially in elderly before we are able to assess the practical consequences of the observed differences.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Boxplots of eGFR based on different estimating equations for men and women in different age groups (values lower than 60 ml/min/1.73 m2 indicating chronic kidney disease stages 3–5; + denoting mean values).
See this image and copyright information in PMC

References

    1. Matsushita K, van der Velde M, Astor BC, Woodward M. Chronic Kidney Disease Prognosis Consortium et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375:2073–2081. - PMC - PubMed
    1. Zhang Q, Rothenbacher D. Prevalence of chronic kidney disease in population-based studies: systematic review. BMC Publ Health. 2008;8:117. doi: 10.1186/1471-2458-8-117. - DOI - PMC - PubMed
    1. Astor BC, Matsushita K, Gansevoort RT, van der Velde M, Woodward M. et al. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts. Kidney Int. 2011;79:1331–1340. doi: 10.1038/ki.2010.550. - DOI - PMC - PubMed
    1. Nitsch D, Mann AG, Bulpitt C, Roderick PJ, Fletcher A. Impairment of kidney function and reduced quality-of-life in older people: a cross-sectional study. Age Ageing. 2011;40:381–387. doi: 10.1093/ageing/afr024. - DOI - PubMed
    1. Levey AS, de Jong PE, Coresh J, Nahas ME, Astor BC. et al. The definition, classification and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2011;80:17–28. doi: 10.1038/ki.2010.483. - DOI - PubMed

Publication types