title: Natural history of older adults with impaired kidney function: the InCHIANTI study.
abstract: The aim of this study was to assess the kidney function of an older community-dwelling population at baseline and appraise its evolution after 3 years of follow-up in terms of chronic kidney disease (CKD) stage progression, magnitude of glomerular filtration rate (GFR) changes, and value of serum creatinine. This was a prospective population-based study of 676 Italian participants, aged 65 years and older. GFR was estimated using the Cockcroft-Gault equation and the Modification of Diet in Renal Disease Study equation. Using the Cockcroft-Gault equation. A total of 33% of participants had criteria of CKD (GFR < 60 mL/min) at baseline; among them, the majority remained stable, 10% improved, and 7% progressed to more severe CKD stages at follow-up. Loss of GFR in participants with GFR < 60 mL/min was significantly lower (1.4 mL/min per year) than in participants with GFR ≥ 60 mL/min (3.3 mL/min per year) at baseline. Most participants classified with CKD stage 2 (GFR 60-89 mL/min) or stage 3 (GFR 30-59 mL/min) at baseline did not change stage, whereas 55% of people with CKD stage 1 (GFR > 90 mL/min) at baseline worsened to stage 2 and 10% worsened to stage 3. An abnormal high level of serum creatinine at baseline did not help to predict who might worsen at follow-up. Older people with CKD displayed a low progression of renal disease and therefore are at higher risk for co-morbidities related to CKD than for progression to end-stage renal disease.
authors.affiliation: Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland. sandra.giannelli@hcuge.ch
authors.forename: Sandra V
authors.initials: SV
authors.lastname: Giannelli
authors.forename: Christophe E
authors.initials: CE
authors.lastname: Graf
authors.forename: François R
authors.initials: FR
authors.lastname: Herrmann
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Michel
authors.forename: Kushang V
authors.initials: KV
authors.lastname: Patel
authors.forename: Francesco
authors.initials: F
authors.lastname: Pizzarelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Jack
authors.initials: J
authors.lastname: Guralnik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007558:Italy; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D055815:Young Adult