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Review
. 2024 Jul 11:11:1397160.
doi: 10.3389/fmed.2024.1397160. eCollection 2024.

Biomarkers of chronic kidney disease in older individuals: navigating complexity in diagnosis

Lucia Muglia #  1 , Michele Di Dio #  2 , Elvira Filicetti  3 , Giada Ida Greco  3 , Mara Volpentesta  3 , Alessia Beccacece  1 , Paolo Fabbietti  1 , Fabrizia Lattanzio  4 , Andrea Corsonello  1   3   5 , Guido Gembillo  6 , Domenico Santoro  6 , Luca Soraci  3
Affiliations
Review

Biomarkers of chronic kidney disease in older individuals: navigating complexity in diagnosis

Lucia Muglia et al. Front Med (Lausanne). .

Abstract

Chronic kidney disease (CKD) in older individuals is a matter of growing concern in the field of public health across the globe. Indeed, prevalence of kidney function impairment increases with advancing age and is often exacerbated by age-induced modifications of kidney function, presence of chronic diseases such as diabetes, hypertension, and cardiovascular disorders, and increased burden related to frailty, cognitive impairment and sarcopenia. Accurate assessment of CKD in older individuals is crucial for timely intervention and management and relies heavily on biomarkers for disease diagnosis and monitoring. However, the interpretation of these biomarkers in older patients may be complex due to interplays between CKD, aging, chronic diseases and geriatric syndromes. Biomarkers such as serum creatinine, estimated glomerular filtration rate (eGFR), and albuminuria can be significantly altered by systemic inflammation, metabolic changes, and medication use commonly seen in this population. To overcome the limitations of traditional biomarkers, several innovative proteins have been investigated as potential, in this review we aimed at consolidating the existing data concerning the geriatric aspects of CKD, describing the challenges and considerations in using traditional and innovative biomarkers to assess CKD in older patients, highlighting the need for integration of the clinical context to improve biomarkers' accuracy.

Keywords: CKD; biomarkers; chronic kidney disease; comprehensive geriatric assessment; frailty; older patients.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Aging-related changes of kidney structure and function.
Figure 2
Figure 2
Classification of plasma and urinary CKD biomarkers according to mechanism of action.
Figure 3
Figure 3
Pathogenic links between CKD, sarcopenia, physical and cognitive frailty.
See this image and copyright information in PMC

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