A longitudinal assessment of the natural rate of decline in renal function with age

Cohen, Eytan; Nardi, Yuval; Krause, Irit; Goldberg, Elad; Milo, Gai; Garty, Moshe; Krause, Ilan

doi:10.1007/s40620-014-0077-9

Cited by 90 publications

(80 citation statements)

References 28 publications

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“…The decline may be related to CKD progression, as it has been reported that during 8-12 years of follow-up, kidney function decline progressed in one third of patients with type 1 diabetes and microalbuminuria with normal or elevated baseline GFR (19). We reported that the absolute annual eGFR decline of 3.0 ml/min per 1.73 m 2 in participants with eGFR$90 ml/min per 1.73 m 2 was three times higher in this "healthy," relatively young group than reported in studies from other populations (14,20). The relatively high rate of eGFR decline in the current study is consistent with higher rates of ESRD among indigenous Australians, with likely multiple contributory factors ranging from socioeconomic disadvantage, early life insults (low birthweight, post-streptococcal GN, recurrent infections), high rates of cigarette smoking, and high rates of metabolic syndrome and diabetes among this high-risk population (21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 51%

Progression of Kidney Disease in Indigenous Australians: The eGFR Follow-up Study

Maple-Brown¹,

Hughes²,

Ritte³

et al. 2016

CJASN

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Background and objectives Indigenous Australians experience a heavy burden of CKD. To address this burden, the eGFR Follow-Up Study recruited and followed an Indigenous Australian cohort from regions of Australia with the greatest ESRD burden. We sought to better understand factors contributing to the progression of kidney disease. Specific objectives were to assess rates of progression of eGFR in Indigenous Australians with and without CKD and identify factors associated with a decline in eGFR.Design, setting, participants, & measurements This observational longitudinal study of Indigenous Australian adults was conducted in .20 sites. The baseline cohort was recruited from community and primary care clinic sites across five strata of health, diabetes status, and kidney function. Participants were then invited to follow up at 2-4 years; if unavailable, vital status, progression to RRT, and serum creatinine were obtained from medical records. Primary outcomes were annual eGFR change and combined renal outcome (first of $30% eGFR decline with follow-up eGFR,60 ml/min per 1.73 m 2 , progression to RRT, or renal death).Results Participants (n=550) were followed for a median of 3.0 years. Baseline and follow-up eGFR (geometric mean [95% confidence interval], 83.9 (80.7 to 87.3) and 70.1 (65.9 to 74.5) ml/min per 1.73 m 2 , respectively. Overall mean annual eGFR change was 23.1 (23.6 to 22.5) ml/min per 1.73 m 2 . Stratified by baseline eGFR ($90, 60-89, ,60 ml/min per 1.73 m 2 ), annual eGFR changes were 23.0 (23.6 to 22.4), 21.9 (23.3 to 20.5), and 25.0 (26.5 to 23.6) ml/min per 1.73 m 2 . Across baseline eGFR categories, annual eGFR decline was greatest among adults with baseline albumin-to-creatinine ratio (ACR) .265 mg/g (30 mg/mmol). Baseline determinants of the combined renal outcome (experienced by 66 participants) were higher urine ACR, diabetes, lower measured GFR, and higher C-reactive protein.Conclusions The observed eGFR decline was three times higher than described in nonindigenous populations. ACR was confirmed as a powerful predictor for eGFR decline across diverse geographic regions.

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Section: Discussionmentioning

confidence: 51%

Progression of Kidney Disease in Indigenous Australians: The eGFR Follow-up Study

Maple-Brown¹,

Hughes²,

Ritte³

et al. 2016

CJASN

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“…One possibility is that compensatory hypertrophy of residual nephrons maintains eGFR in some elderly populations [31]. This could explain (at least to some extent) the inter-individual differences seen in eGFR in elderly populations [32-34]. …”

Section: Structural and Functional Changes In Renal Ageingmentioning

confidence: 99%

“…Multiple studies report variable age-associated decline in eGFR from 0.4-2.6 ml/min/year [33, 34, 36, 43, 44]. The rate of decline increases with age.…”

Section: Structural and Functional Changes In Renal Ageingmentioning

confidence: 99%

Tick-Tock Chimes the Kidney Clock – from Biology of Renal Ageing to Clinical Applications

Rowland

Akbarov

Maan

et al. 2018

Kidney Blood Press Res

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Ageing of the kidney is a multi-dimensional process that occurs simultaneously at the molecular, cellular, histological, anatomical and physiological level. Nephron number and renal cortical volume decline, renal tubules become atrophic and glomeruli become sclerotic with age. These structural changes are accompanied by a decline in glomerular filtration rate, decreased sodium reabsorption and potassium excretion, reduced urinary concentrating capacity and alterations in the endocrine activity of the kidney. However, the pace of progression of these changes is not identical in everyone - individuals of the same age and seemingly similar clinical profile often exhibit stark differences in the age-related decline in renal health. Thus, chronological age poorly reflects the time-dependent changes that occur in the kidney. An ideal measure of renal vitality is biological kidney age – a measure of the age-related changes in physiological function. Replacing chronological age with biological age could provide numerous clinical benefits including improved prognostic accuracy in renal transplantation, better stratification of risk and identification of those who are on a fast trajectory to an age-related drop in kidney health.

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“…Hekimlerin, yaşlıların tedavisinde, sayılan bu özelliklerin gereklerine uygun davranması şarttır. [47][48][49][50][51][52] Bu yaş grubunda eşlik eden hastalıklar nedeni ile ilaç kullanımı daha fazla olduğundan, hastaya verilmesi planlanan antibiyotiğin, kullanılmakta olan diğer ilaçlarla olası etkileşimi de göz önünde bulundurulmalıdır. Bununla birlikte, yaşlılarda meydana gelen birtakım fizyolojik değişiklikler nedeni ile antibiyotiklerin emilim, dağılım, proteinlere bağ-lanma ve eliminasyonu etkilenebilmektedir.…”

Section: Yaşlilarda Anti̇bi̇yoti̇k Kullanimiunclassified

“…51 Ayrıca, yaşla birlikte böbrek fonksiyonları da azalmaktadır. 52 Diş hekimliğinde kullanılan yukarıda sözü edilen antibiyotiklerin karaciğer-den metabolize edilerek ve/veya böbreklerden atılarak elimine edildiği bilinmektedir. Dolayısıyla yaşlılıkta antibiyotiklerin eliminasyonunda yetersizlik oluşabileceği ve buna bağlı yan/karşıt etki sıklık ve şiddetinin artabileceği göz önünde bulundurulmalı, tedavi mümkün olduğunca bireyselleş-tirilmelidir.…”

Section: Yaşlilarda Anti̇bi̇yoti̇k Kullanimiunclassified

The Rational Use of Antibiotics in Dentistry: Review

Aydın¹,

Koyuncuoğlu²,

Kilboz³

et al. 2017

Turkiye Klinikleri J Dental Sci

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A longitudinal assessment of the natural rate of decline in renal function with age

Cited by 90 publications

References 28 publications

Progression of Kidney Disease in Indigenous Australians: The eGFR Follow-up Study

Progression of Kidney Disease in Indigenous Australians: The eGFR Follow-up Study

Tick-Tock Chimes the Kidney Clock – from Biology of Renal Ageing to Clinical Applications

The Rational Use of Antibiotics in Dentistry: Review

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