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Abstract: PO2334

Epidemiology of CKD Based on Age-Adapted GFR Thresholds

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Jonsson, Arnar Jan, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
  • Lund, Sigrún Helga, deCODE Genetics Inc, Reykjavik, Capital, Iceland
  • Palsson, Runolfur, Internal Medicine Services, Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland
  • Indridason, Olafur S., Division of Nephrology, Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland
Background

Age-adapted GFR criteria for definition of chronic kidney disease (CKD) have been proposed to account for normal age-related decline in kidney function. The aim of this study was to determine the prevalence and incidence of CKD stages 1-5 based on age-adapted GFR thresholds compared with current KDIGO GFR criteria.

Methods

In this retrospective study, we obtained all serum creatinine (SCr) values and urine protein measurements from every clinical laboratory in Iceland in 2008-2016. Clinical data, including ICD-10 diagnosis codes, were retrieved from nationwide electronic medical records. Estimated GFR was calculated from SCr using the CKD-EPI equation. CKD was defined as presence of kidney damage, either proteinuria or ICD-10 diagnosis codes indicative of kidney disease, or reduced eGFR for ≥3 months. Reduced eGFR was defined as <60 mL/min/1.73 m2 according to the standard KDIGO criteria or based on the following age-adapted thresholds: <75 mL/min/1.73 m2 for age <40 years, <60 mL/min/1.73 m2 for 40-65 years and <45 mL/min/1.73 m2 for age ≥65 years. Incidence of CKD was calculated in individuals without evidence of CKD at study entry. Prevalence and incidence were standardized to the EU-27 population.

Results

We obtained 2,120,147 SCr values for 218,437 individuals. The median age was 46 (range, 18-107) years; 47% were men. A total of 25,996 individuals met the KDIGO criteria for CKD compared with 17,593 when the age-adapted criteria were applied. The mean annual age-standardized prevalence per 100,000 overall and for men and women was 5940, 5130 and 6750, respectively, using the KDIGO criteria, and 3640, 3270 and 4010, respectively, applying the age-adapted GFR thresholds. The mean annual age-standardized incidence of CKD per 100,000 overall and for men and women was 671, 649 and 694, respectively, using the KDIGO criteria and 501, 480 and 522, respectively, applying the age-adapted thresholds.

Conclusion

This nationwide Icelandic study comprising SCr values and other markers of kidney damage for the majority of the Icelandic population demonstrates a markedly lower CKD prevalence and incidence with use of age-adapted GFR thresholds as compared with the standard KDIGO criteria.

Funding

  • Government Support – Non-U.S.