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Kidney Week

Abstract: TH-PO394

eGFR Trajectory in Old Age

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Schaeffner, Elke, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • Ebert, Natalie, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • van der Giet, Markus, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • Kuhlmann, Martin K., Vivantes Klinikum im Friedrichshain, Berlin, Germany
  • Martus, Peter, UKT Tübingen, Tübingen, Germany
  • Mielke, Nina, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • Schneider, Alice, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • Huscher, Doerte, Charité-Universitätsmedizin Berlin, Berlin, Germany
Background

Longitudinal data about the natural course of estimated glomerular filtration rate (eGFR) among older adults over several years are scarce. The Berlin Initiative Study (BIS) aims to fill this gap by evaluating repeat assessments of eGFR over time and potential risk factors for GFR decline in older adults.

Methods

The BIS is a prospective population-based cohort study initiated in 2009 whose participants are members of a German insurance company with the biggest fraction of older adults. Participants were interviewed face-to-face biannually using a standardized questionnaire recording clinical, laboratory and patient reported outcomes. eGFR was calculated with the BIS2(crea/cysC) formula. The course of eGFR was analyzed with a linear mixed-effects model, comprising age, sex, diabetes mellitus (DM), smoking status, body mass index (BMI), systolic blood pressure (sysBP), albumin-creatinine ratio (ACR), serum creatinine, cystatin C, ACE inhibitors, AT1 antagonists, NSAID, number of regular drugs, and myocardial infarction (all time-dependent), applying multiple imputation for missing data.

Results

As of May 06, 2019, 2,069 participants (47.4% male, mean age 80.4 years at inclusion) were followed for a median of 6.0 years. Of those, 1,699 (82%) had at least 2 eGFR assessments. We observed higher eGFR values in men. Crude linear regression lines of the eGFR course suggested a continuous decline, which decreased with rising age. In the mixed linear effects model, age, sex, BMI, myocardial infarction, current smoking, sysBP, use of sartanes and the number of regular drugs had a significant impact on eGFR.

Conclusion

Taking into account the potential impact of clinical, therapeutically and behavioral variables, we still observed an age-dependent decrease of eGFR, suggesting a naturally declining course in older age. The mixed model reveals that the expected mean eGFR for men aged ≥79 and women ≥78 is below 60, defining deficient kidney function when using the current classification system.

Funding

  • Private Foundation Support