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Kidney Week

Abstract: SA-PO411

Prediction of Mortality in Elderly Patients with CKD – The Role of Cystatin C and Other GFR Markers

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 302 CKD: Estimating Equations, Incidence, Prevalence, Special Populations

Authors

  • Bevc, Sebastjan, University Clinical Centre Maribor, Maribor, Slovenia
  • Hojs, Nina, University Clinical Centre Maribor, Maribor, Slovenia
  • Knehtl, Masa, University Clinical Centre Maribor, Maribor, Slovenia
  • Ekart, Robert, UKC Maribor, Maribor, Slovenia
  • Hojs, Radovan, University Clinical Centre Maribor, Maribor, Slovenia
Background

The prevalence of chronic kidney disease (CKD) in the elderly is high. Serum cystatin C is accurate marker of kidney function and has also prognostic utility in CKD patients.
The aim of our study was to determine the prediction of cystatin C and other markers of kidney function on long-term survival in elderly CKD patients.

Methods

58 adult Caucasian patients, older than 65 years (50% women; mean age 73 years; range from 65 to 85 years), were included. Patients with known malignancy, on steroid therapy and/or thyroid disease were not enrolled in the study. In each patient 51CrEDTA clearance, serum creatinine (IDMS traceable method), serum cystatin C (immunonephelometric method) and eGFR using three formulas (CKD-EPI creatinine, BIS2 and FAS) were determined on the same day and patients were then followed for 11 years or until their death.

Results

The means: 51CrEDTA clearance 53.3±17.4 ml/min/1.73m2, serum creatinine 143.4±44 µmol/l, serum cystatin C 1.79±0.5 mg/l, CKD-EPI creatinine 40.3±14.2, BIS2 39.3±10.9, FAS 31±10.4 ml/min/1.73m2, respectively. In the follow up period of 11 years 47 (81%) of our elderly CKD patients (23 women and 24 men) died. Cox regression analysis showed different hazard ratios (HR) for death: for 51CrEDTA clearance HR 0.978 (95% CI 0.960-0.996; P=0.015), serum creatinine HR 1.013 (95% CI 1.006-1.019; P<0.001), serum cystatin C HR 2.028 (95% CI 1.269-3.241; P=0.003), CKD-EPI creatinine HR 0.953 (95% CI 0.928-0.980; P=0.001), BIS2 HR 0.947 (95% CI 0.918-0.977; P=0.001), FAS HR 0.946 (95% CI 0.914-0.979; P=0.002).

Conclusion

Our results showed the highest hazard ratio for serum cystatin C values among the markers of kidney function for prediction of the outcome in elderly CKD patients.