Treatment plans and outcomes in elderly patients reaching advanced chronic kidney disease

Moranne, Olivier; Fafin, Coraline; Roche, Sophie; François, Maud; Allot, Vincent; Potier, Jérôme; Babici, Daniela; Lobbedez, Thierry; Matignon, Marie; Mariat, Christophe; Vigneau, Cécile; Couchoud, Cécile

doi:10.1093/ndt/gfy046

Cited by 16 publications

(29 citation statements)

References 28 publications

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“…Considering that the risk factors for renal impairment, such as diabetes mellitus (DM) and hypertension, are increasing with improved life expectancy, renal dysfunction in the elderly is expected to become more frequent [2]. Since renal dysfunction is associated with higher morbidity and mortality in the elderly [2, 3], further studies are needed to assess and diagnose it in this population. Although several parameters have been reported as biomarkers for estimating renal function, few studies have explored them in the elderly [4].…”

Section: Introductionmentioning

confidence: 99%

Association between Plasma Levels of Growth Differentiation Factor-15 and Renal Function in the Elderly: Korean Frailty and Aging Cohort Study

Kim

Won

et al. 2019

Kidney Blood Press Res

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Background/Aims: Growth differentiation factor-15 (GDF-15) expression has been reported to increase in response to tissue damage and has recently emerged as a useful biomarker for various diseases. Although emerging evidence supports the clinicopathological value of GDF-15 in renal impairment, few studies have analyzed it in the elderly. Thus, we conducted a cross-sectional study to investigate the association of plasma GDF-15 with renal function and the presence of chronic kidney disease (CKD) in community-dwelling elderly. Materials: The present study was based on the baseline data of the Korean Frailty and Aging Cohort Study (KFACS), a nationwide cohort study that began in 2016. Of the 1,559 participants assessed in the first year, 443 with available plasma GDF-15 data were enrolled in this study. We investigated the association of plasma GDF-15 levels with clinical and biochemical parameters. The study population was divided into two groups according to renal function (CKD and non-CKD groups) to investigate whether GDF-15 can determine the presence of renal dysfunction in the elderly. Plasma GDF-15 was measured by enzyme-linked immunosorbent assay (ELISA) kit. Results: In a simple regression analysis, the levels of plasma GDF-15 were negatively correlated with estimated glomerular filtration rate (eGFR; r = –0.383, p < 0.001). In multiple linear regression analysis, GDF-15 levels were still significantly correlated with eGFR, even after adjusting for other parameters (r = –0.259, p < 0.001). Plasma GDF-15 levels were significantly higher in the elderly with CKD than in those without CKD (2,364.025 ± 1,052.23 ng/L and 1,451.23 ± 835.79 ng/L, respectively; p < 0.001). The optimal cut-off value of plasma GDF-15 for detecting the presence of CKD was 1,699.4 ng/L (76.5% sensitivity and 76.0% specificity), as determined by the receiver operating characteristic curve. The area under the curve was 0.793 ± 0.033 (95% CI 0.729–0.857, p < 0.001). Conclusion: Plasma GDF-15 levels were negatively associated with eGFR and were significantly increased in the elderly with CKD. Our results suggested that plasma GDF-15 might be a useful marker for discriminating renal impairment in the elderly. Further large and prospective outcome studies of extended duration are needed.

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Section: Introductionmentioning

confidence: 99%

Association between Plasma Levels of Growth Differentiation Factor-15 and Renal Function in the Elderly: Korean Frailty and Aging Cohort Study

Kim

Won

et al. 2019

Kidney Blood Press Res

View full text Add to dashboard Cite

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“…Although the study included a more significant number of patients (938) and was multicenter, it also had a smaller number of diabetic patients (23.8%) compared to the Japanese (37%), Turkish (41.4%) or in our study (30%), and could explain these differences, due to the higher mortality in diabetic patients (28). Similarly, the mean age of the Chinese patients was comparatively lower (52.8) than that of the patients in the Japanese (68), Turkish (73.8) and our studies (78.3), which is essential because older age is associated with higher mortality in CKD (29).…”

Section: Discussionmentioning

confidence: 44%

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as a risk factor for mortality in peruvian adults with chronic kidney disease.

Umeres-Francia

Rojas-Fernández

Herrera-Añazco

et al. 2021

Preprint

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Objective: To assess the association between NLR and PLR with all-cause mortality in Peruvian patients with CKD Methods: We conducted a retrospective cohort study in adults with CKD in stages 1 to 5. The outcome variable was mortality and as variables of exposure to NLR and PLR. Both ratios were categorized as high with a cut-off point of 3.5 and 232.5; respectively. We carried out a Cox regression model and calculated crude and adjusted hazard ratios (HR) with their 95% confidence interval (95%CI). Results: We analyzed 343 participants with a median follow-up time of 2.45 years (2.08-3.08). The frequency of deaths was 17.5% (n=60). In the crude analysis, the high NLR and PLR were significantly associated with all-cause mortality (HR=2.01; 95% CI:1.11-3.66) and (HR=2.58; 95% CI:1.31-5.20). In the multivariate model, after adjusting for age, sex, serum creatinine, CKD stage, albumin and hemoglobin, the high NLR and PLR remained as an independent risk factor for all-cause mortality, (HR=2.10; 95% CI:1.11-3.95) and (HR=2.71; 95% CI:1.28-5.72). Conclusion: Our study suggests the relationship between high NLR and PLR with all-cause mortality in patients with CKD.

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“…Several reports during the early 2000s suggested that in patients aged �75 years with multiple extrarenal comorbidities are unlikely to benefit from RRT in terms of the survival time outside the hospital setting and quality of life [25] [26] [27]. Patient and families are increasingly implicated in planning of care, and information about the possibility of conservative renal care by health care providers [28] [29]. It is likely that these factors will influence the uptake of conservative care over time.…”

Section: Countrymentioning

confidence: 99%

Variability in the incidence of renal replacement therapy over time in Western industrialized countries: A retrospective registry analysis

et al. 2020

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Introduction A growing number of patients started renal replacement therapy (RRT) in Western industrialized countries between 1980 an early 2000s. Thereafter reports from national and international registries suggest a trend towards stabilization and sometimes a decrease in the incidence rate. Aim To investigate the differences in overall and age-specific incidence rates between industrialized countries from 1998 until 2013. Secondly, to investigate changes in incidence rates over time and their association with specific age categories. Method We extracted the unadjusted overall incidence of RRT and age-specific incidence rates from renal registry reports in Europe, the United States, Canada, Australia and New Zealand. Time trends in the incidence rate by country and age categories were analyzed by Joinpoint regression analysis. Results The incidence rate in 2013 ranged from 89 per million population (pmp) in Finland to 363 pmp in the US. Incidence rates in the lower age categories (20-64 year) were similar between countries and remained stable over time. Higher incidence countries were

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Treatment plans and outcomes in elderly patients reaching advanced chronic kidney disease

Cited by 16 publications

References 28 publications

Association between Plasma Levels of Growth Differentiation Factor-15 and Renal Function in the Elderly: Korean Frailty and Aging Cohort Study

Association between Plasma Levels of Growth Differentiation Factor-15 and Renal Function in the Elderly: Korean Frailty and Aging Cohort Study

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as a risk factor for mortality in peruvian adults with chronic kidney disease.

Variability in the incidence of renal replacement therapy over time in Western industrialized countries: A retrospective registry analysis

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