title: The evolution of renal function and the incidence of end-stage renal disease in patients aged ≥ 50 years.
abstract: BACKGROUND
  The prevalence of chronic kidney disease (CKD) is high, especially among older patients.
  
  
  METHODS
  In order to identify risk factors for the evolution towards end-stage renal disease (ESRD), a cohort of patients ≥ 50 years of age for whom at least four serum creatinine measurements were available were selected from a primary care-based database. The slope of changes in estimated glomerular filtration rate (eGFR) (using the Modification of Diet in Renal Disease formula) was calculated, and ESRD was defined as eGFR <15 mL/min. Risk factors for ESRD were analysed using Cox regression analysis.
  
  
  RESULTS
  The cohort included 24,682 patients (13,305 women) with a mean age at first available measurement of 64 years. During follow-up (average 7.8 years), 212 patients (0.9%) developed ESRD. The incidence of ESRD per 10,000 person-years is low and depends on baseline eGFR (Stages 0-2: 3, Stage 3A: 13, Stage 3B: 121 and Stage 4: 765). Adjusted hazard ratios (HRs) for patients with baseline eGFR in Stage 3B or 4 depended on age (HR = 0.47 or 0.41 for patients 65-79 years and HR = 0.26 or 0.32 for patients ≥ 80 years compared with patients aged 50-64 years). Females (HR = 1.48) and patients with diabetes (HR = 1.20), hypertension (HR = 1.25), high total cholesterol (HR = 1.28) or high low-density lipoprotein (LDL) cholesterol (HR = 1.39) were at higher risk for ESRD.
  
  
  CONCLUSIONS
  Baseline eGFR, diabetes, high cholesterol, high LDL, hypertension and female gender are independent risk factors for developing ESRD. Older age at baseline predicts a lower risk.
authors.affiliation: Department of General Practice, Katholieke Universiteit Leuven, Leuven, Belgium. gijs.vanpottelbergh@med.kuleuven.be
authors.forename: Gijs
authors.initials: G
authors.lastname: Van Pottelbergh
authors.forename: Stephaan
authors.initials: S
authors.lastname: Bartholomeeusen
authors.forename: Frank
authors.initials: F
authors.lastname: Buntinx
authors.forename: Jan
authors.initials: J
authors.lastname: Degryse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000401:mortality; D012307:Risk Factors; D015996:Survival Rate