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Kidney Week

Abstract: SA-PO717

Is Healthy Aging Associated with Preserved Kidney Function?

Session Information

  • Geriatric Nephrology
    October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Eriksen, Bjorn Odvar, UiT The Arctic University of Norway, Tromsø, Norway
  • Ebert, Natalie, Charite University Hospital, Belgrade, Serbia
  • Indridason, Olafur S., Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
  • Melsom, Toralf, University Hospital of North Norway, Tromso, Norway
  • Palsson, Runolfur, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
  • Schaeffner, Elke, Charite , Berlin, Germany
Background

Studies of kidney function based on creatinine in older adults have indicated a wide variation in age-related GFR decline and that healthy persons age with a well-preserved GFR. However, estimated GFR from creatinine is problematic in this age group because of confounding by sarcopenia. We investigated variation of measured GFR in the general population to study whether healthy ageing is associated with a stable GFR.

Methods

We measured iohexol clearance in three European cohorts (AGES-II-Reykjavik Study, Berlin Initiative Study and Renal Iohexol Clearance Survey (RENIS)) representative of the general population aged 50 to 97 years. The iohexol assays were calibrated across cohorts. We also registered the most important prevalent diseases representing risk factors for chronic kidney disease (diabetes, hypertension, cardiovascular disease and cancer). We predicted the median, 2.5th and 97.5th percentiles of cross-sectional GFR by age for persons without these risk factors using generalized additive quantile mixed models.

Results

We included 3002 persons. For persons > 90 years, the maximum observed GFR was 78 mL/min/1.73 m2. For a person free from diabetes, hypertension, cardiovascular disease and cancer, the predicted 2.5th, 50thand 97.5th percentiles of GFR uniformly declined across the investigated age range. At 90 years, the predicted GFR values at these percentiles were 47, 64 and 78 mL/min/1.73 m2, respectively. The 2.5th percentile crossed the 60 mL/min/1.73 m2 level at 71.5 years and the 45 mL/min/1.73 m2 level at 91.6 years (Figure).

Conclusion

Persons without the most important risk factors for chronic kidney disease are not exempt from age-related GFR decline. This indicates that GFR decline in these persons is caused by general ageing rather than by kidney disease.

Points are individual measurements of GFR. Line (dashed lines) are predicted median (2.5th and 95th percentiles) under the statistical model for a person without diabetes, hypertension, CVD or cancer. Dotted horizontal lines indicate 45 and 60 ml/min/1.73 m2.

Funding

  • Government Support - Non-U.S.