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Abstract: FR-PO877

Prevalence of CKD in Older Adults by Different Filtration Markers in eGFR Equations

Session Information

  • Geriatric Nephrology
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1300 Geriatric Nephrology

Authors

  • Flaherty, Carina M., NYU Langone Health, New York, New York, United States
  • Surapaneni, Aditya L., NYU Langone Health, New York, New York, United States
  • Grams, Morgan, NYU Langone Health, New York, New York, United States
  • Seegmiller, Jesse C., University of Minnesota Twin Cities School of Medicine, Minneapolis, Minnesota, United States
  • Coresh, Josef, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Ballew, Shoshana, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
Background

The prevalence of chronic kidney disease (CKD) is known to increase with age, but few studies investigate age specific prevalence and progression of CKD in populations over 65. Glomerular filtration rate (GFR) can be estimated using different filtration markers that have not been thoroughly studied in older populations, opening the door for research on how these markers may differentially characterize the prevalence and progression of CKD in older age.

Methods

The study population included a community-based sample of 6,393 White and Black participants aged 65-100 stratified into 5-year age categories from Visit 5 of the Atherosclerosis Risk in Communities Study (ARIC). GFR was estimated using CKD-EPI (2021) and Inker et al (2021) equations, and by the following combinations of filtration markers: creatinine (eGFRcr), cystatin C (eGFRcys), both (eGFRcr-cys), and combined with beta-2-microglobulin (eGFRcr-cys-b2m). We calculated the proportion of participants with eGFR <60 ml/min/1.73 m2 by each marker equation across age strata at Visit 5 (2011-2013), 6 (2016-2017), and 7 (2018-2019), and calculated the proportion of participants with a 30% decline in eGFR at ARIC Visit 6 or 7, across age strata.

Results

Average age at Visit 5 was 75.8 years (SD, 5.3). Mean eGFRcr, eGFRcys, eGFRcr-cys, and eGFRcr-cys-b2m were 71, 61, 68, and 65 ml/min/1.73 m2, respectively. The proportion with eGFR <60 was lowest with eGFRcr and highest with eGFRcys for all age groups at all visits, and prevalence increased with age for all markers (Figure 1). More people with eGFRcr ≥60 were reclassified to <60 when using eGFRcys (33%) compared with eGFRcr-cys (12%) or eGFRcr-cys-b2m (18%). The proportion with 30% eGFR decline was lowest with eGFRcr and highest with eGFRcys, with greater incidence in older age groups for all markers.

Conclusion

The prevalence and progression of CKD increases with age but varies depending on filtration marker used. Creatinine underestimates CKD compared to other filtration markers.

Funding

  • NIDDK Support