title: Association of reduced kidney function with cardiovascular disease and mortality in elderly patients: comparison between the new Berlin initiative study (BIS1) and the MDRD study equations.
abstract: BACKGROUND
  New creatinine based equations for estimating glomerular proposed for aged subjects have not been assessed in their association of reduced eGFR with cardiovascular (CV) morbidity or all cause (AC) mortality.
  
  
  METHODS
  All subjects ≥70 years old (2998) who had been admitted to the hospital during a 12 month period were examined.
  
  
  METHODS
  In a cohort study we applied the new Berlin Initiative Study (BIS1) equation. We compared the association of reduced eGFR estimated by BIS1 and MDRD equations, with cardiovascular (CV) disease and all cause (AC) mortality.
  
  
  RESULTS
  eGFR was 57 ± 17 mL/min/1.73 m2by MDRD and 71 ± 28 mL/min/1.73 m2by BIS1 (P < 0.001). A diagnosis of CV disease was present in 947 patients. CV disease was associated with eGFR < 60 mL/min/1.73 m2by both formulas: OR 1.179 (CI 1.001-1.390) for BIS1 and OR 1.440 (CI 1.223-1.696) for MDRD. In survival analysis a significant association of eGFR < 60 mL/min/1.73 m2with AC mortality was found for both equations: MDRD (HR = 1.270, CI 1.111-1.453, P < 0.001), BIS1 (HR = 1.174, CI 1.031-1.338, P = 0.016). The analysis repeated with groups of age showed that the association of mortality with eGFRBIS1< 60 mL/min/1.73 m2was lost over 80 years.
  
  
  CONCLUSIONS
  In patients >70, admitted to hospital, the implementation of the new BIS1 estimating equation does not modify the relationship, observed with the MDRD formula, of reduced GFR with CV disease or AC mortality.
authors.affiliation: Renal Unit, Ospedale Santa Maria della Misericordia, Perugia, Italy. atlosito@tin.it.
authors.forename: Attilio
authors.initials: A
authors.lastname: Losito
authors.affiliation: Institute of Geriatrics and Gerontology, Department of Clinical and Experimental Medicine, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy.
authors.forename: Ivano
authors.initials: I
authors.lastname: Zampi
authors.affiliation: Renal Unit, Ospedale Santa Maria della Misericordia, Perugia, Italy.
authors.forename: Loretta
authors.initials: L
authors.lastname: Pittavini
authors.affiliation: Institute of Geriatrics and Gerontology, Department of Clinical and Experimental Medicine, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Zampi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male
keywords: Cardiovascular disease; Equations; GFR; Mortality