title: Loss of renal function in the elderly Italians: a physiologic or pathologic process?
abstract: BACKGROUND
  Nowadays it seems that chronic kidney disease (CKD) is outbreaking, mostly in the elderly participants. The aim of this study was to assess the progression of CKD in different ages.
  
  
  METHODS
  We conducted a monocentric, retrospective, observational study enrolling 116 patients afferent to our outpatient clinic.
  
  
  METHODS
  age >18 years, follow-up ≥5 years, estimated glomerular filtration rate (eGFR) <60mL/min/1.73 m(2), and/or diagnosed renal disease and/or presence of renal damage. Patients were divided into four groups according to their age: 25-55 years (n = 27), 56-65 (25), 66-75 (42), and 76-87 (22). eGFR was calculated using the modification of diet in renal disease and the CKD-epidemiology collaboration formulas.
  
  
  RESULTS
  Younger patients had a significantly longer follow-up and less comorbidities, evaluated by the cumulative illness rating scale score, compared with the other groups. There was no difference between creatinine at baseline and at the end-of-follow-up period among the groups. Even though renal function significantly decreased in all groups, we noticed a slower progression as the age increased, and the difference between basal and end-of-follow-up eGFR was minimal in the group of patients aged 76-87 years. Analyzing the eGFR of every ambulatory control plotted against the year of follow-up, we showed a more rapid loss of filtrate in the younger group. Instead, loss of renal function decreased as the age of patients increased.
  
  
  CONCLUSIONS
  This study demonstrates that, in elderly Italian participants, progression of CKD occurs more slowly than in younger patients. This implies that we may probably face an epidemic of CKD but that most of elderly patients diagnosed with CKD may not evolve to end-stage renal disease and require renal replacement therapy.
authors.affiliation: Unit of Nephrology, IRCCS Fondazione Salvatore Maugeri, University of Pavia, Via Maugeri 10, 27100 Pavia, Italy. espositociro56@live.it
authors.forename: Ciro
authors.initials: C
authors.lastname: Esposito
authors.forename: Massimo
authors.initials: M
authors.lastname: Torreggiani
authors.forename: Marta
authors.initials: M
authors.lastname: Arazzi
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Serpieri
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Scaramuzzi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Manini
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Grosjean
authors.forename: Vittoria
authors.initials: V
authors.lastname: Esposito
authors.forename: Davide
authors.initials: D
authors.lastname: Catucci
authors.forename: Edoardo
authors.initials: E
authors.lastname: La Porta
authors.forename: Antonio
authors.initials: A
authors.lastname: Dal Canton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D031204:Caloric Restriction; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000473:pathology* / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D003404:Creatinine