Prevalence of chronic kidney disease in the elderly using the ASPirin in Reducing Events in the Elderly study cohort

Kevan R. Polkinghorne, Rory Wolfe, Kim M. Jachno, James B. Wetmore, Robyn L. Woods, John J. McNeil, Mark R. Nelson, Christopher M. Reid, Anne M. Murray, on behalf of the ASPREE Investigator Group

Research output: Contribution to journalArticleResearchpeer-review

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Abstract

Aim: The prevalence of chronic kidney disease (CKD) in the elderly is controversial because age-related decline in kidney function may not truly reflect underlying kidney disease. We estimate the baseline prevalence and predictors of CKD using the CKD Epidemiology Collaboration (CKD-EPI eGFR ) and Berlin Initiative Study 1 (BIS1 eGFR ) eGFR equations in the ASPirin in Reducing Events in the Elderly (ASPREE) trial cohort of healthy older participants. Methods: GFR was estimated using CKD-EPI and BIS1 equations. CKD was defined as eGFR <60 mL/min/1.73 m 2 or ≥ 60 mL/min/1.73 m 2 with urine albumin creatinine ratio (UACR) ≥ 3 mg/mmol. Logistic regression was used to identify predictors of CKD prevalence defined by each eGFR equation. Results: Data for analysis were complete for 17,762 participants. Mean age was 75.1 years (SD 5); 56.4% were female, 76.4% had hypertension, 9% had diabetes mellitus. Mean CKD-EPI eGFR was 73.0 (SD 14.2), compared with mean BIS1 eGFR of 62.7 (11.4). Median UACR was 0.8 (IQR 0.5, 1.5) mg/mmol. Prevalence of CKD by CKD-EPI eGFR was 27% (predominantly due to normoalbuminuric stage 3a CKD), substantially lower than 47.1% by BIS1 eGFR ; the difference was predominantly driven by reclassification of individuals from G1 and G2 CKD to stage G3a without albuminuria. Increased prevalence of CKD by either equation was related to older age, hypertension, diabetes, or higher body mass index. Conclusions: Prevalence of CKD with CKD-EPI eGFR was 27%, and doubled using the elderly specific BIS1 eGFR , with most participants reclassified from stage 2 to stage 3a. Increased prevalence of CKD was related older age, hypertension, diabetes, or increased body mass index.

Original languageEnglish
Number of pages9
JournalNephrology
DOIs
Publication statusAccepted/In press - 20 Jan 2019

Keywords

  • albuminuria
  • chronic kidney disease
  • elderly
  • estimated glomerular filtration rate
  • prevalence

Cite this

@article{b0371eeb9d984cedb2388055c6c4c432,
title = "Prevalence of chronic kidney disease in the elderly using the ASPirin in Reducing Events in the Elderly study cohort",
abstract = "Aim: The prevalence of chronic kidney disease (CKD) in the elderly is controversial because age-related decline in kidney function may not truly reflect underlying kidney disease. We estimate the baseline prevalence and predictors of CKD using the CKD Epidemiology Collaboration (CKD-EPI eGFR ) and Berlin Initiative Study 1 (BIS1 eGFR ) eGFR equations in the ASPirin in Reducing Events in the Elderly (ASPREE) trial cohort of healthy older participants. Methods: GFR was estimated using CKD-EPI and BIS1 equations. CKD was defined as eGFR <60 mL/min/1.73 m 2 or ≥ 60 mL/min/1.73 m 2 with urine albumin creatinine ratio (UACR) ≥ 3 mg/mmol. Logistic regression was used to identify predictors of CKD prevalence defined by each eGFR equation. Results: Data for analysis were complete for 17,762 participants. Mean age was 75.1 years (SD 5); 56.4{\%} were female, 76.4{\%} had hypertension, 9{\%} had diabetes mellitus. Mean CKD-EPI eGFR was 73.0 (SD 14.2), compared with mean BIS1 eGFR of 62.7 (11.4). Median UACR was 0.8 (IQR 0.5, 1.5) mg/mmol. Prevalence of CKD by CKD-EPI eGFR was 27{\%} (predominantly due to normoalbuminuric stage 3a CKD), substantially lower than 47.1{\%} by BIS1 eGFR ; the difference was predominantly driven by reclassification of individuals from G1 and G2 CKD to stage G3a without albuminuria. Increased prevalence of CKD by either equation was related to older age, hypertension, diabetes, or higher body mass index. Conclusions: Prevalence of CKD with CKD-EPI eGFR was 27{\%}, and doubled using the elderly specific BIS1 eGFR , with most participants reclassified from stage 2 to stage 3a. Increased prevalence of CKD was related older age, hypertension, diabetes, or increased body mass index.",
keywords = "albuminuria, chronic kidney disease, elderly, estimated glomerular filtration rate, prevalence",
author = "Polkinghorne, {Kevan R.} and Rory Wolfe and Jachno, {Kim M.} and Wetmore, {James B.} and Woods, {Robyn L.} and McNeil, {John J.} and Nelson, {Mark R.} and Reid, {Christopher M.} and Murray, {Anne M.} and {on behalf of the ASPREE Investigator Group}",
year = "2019",
month = "1",
day = "20",
doi = "10.1111/nep.13565",
language = "English",
journal = "Nephrology",
issn = "1320-5358",
publisher = "Wiley-Blackwell",

}

Prevalence of chronic kidney disease in the elderly using the ASPirin in Reducing Events in the Elderly study cohort. / Polkinghorne, Kevan R.; Wolfe, Rory; Jachno, Kim M.; Wetmore, James B.; Woods, Robyn L.; McNeil, John J.; Nelson, Mark R.; Reid, Christopher M.; Murray, Anne M.; on behalf of the ASPREE Investigator Group.

In: Nephrology, 20.01.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Prevalence of chronic kidney disease in the elderly using the ASPirin in Reducing Events in the Elderly study cohort

AU - Polkinghorne, Kevan R.

AU - Wolfe, Rory

AU - Jachno, Kim M.

AU - Wetmore, James B.

AU - Woods, Robyn L.

AU - McNeil, John J.

AU - Nelson, Mark R.

AU - Reid, Christopher M.

AU - Murray, Anne M.

AU - on behalf of the ASPREE Investigator Group

PY - 2019/1/20

Y1 - 2019/1/20

N2 - Aim: The prevalence of chronic kidney disease (CKD) in the elderly is controversial because age-related decline in kidney function may not truly reflect underlying kidney disease. We estimate the baseline prevalence and predictors of CKD using the CKD Epidemiology Collaboration (CKD-EPI eGFR ) and Berlin Initiative Study 1 (BIS1 eGFR ) eGFR equations in the ASPirin in Reducing Events in the Elderly (ASPREE) trial cohort of healthy older participants. Methods: GFR was estimated using CKD-EPI and BIS1 equations. CKD was defined as eGFR <60 mL/min/1.73 m 2 or ≥ 60 mL/min/1.73 m 2 with urine albumin creatinine ratio (UACR) ≥ 3 mg/mmol. Logistic regression was used to identify predictors of CKD prevalence defined by each eGFR equation. Results: Data for analysis were complete for 17,762 participants. Mean age was 75.1 years (SD 5); 56.4% were female, 76.4% had hypertension, 9% had diabetes mellitus. Mean CKD-EPI eGFR was 73.0 (SD 14.2), compared with mean BIS1 eGFR of 62.7 (11.4). Median UACR was 0.8 (IQR 0.5, 1.5) mg/mmol. Prevalence of CKD by CKD-EPI eGFR was 27% (predominantly due to normoalbuminuric stage 3a CKD), substantially lower than 47.1% by BIS1 eGFR ; the difference was predominantly driven by reclassification of individuals from G1 and G2 CKD to stage G3a without albuminuria. Increased prevalence of CKD by either equation was related to older age, hypertension, diabetes, or higher body mass index. Conclusions: Prevalence of CKD with CKD-EPI eGFR was 27%, and doubled using the elderly specific BIS1 eGFR , with most participants reclassified from stage 2 to stage 3a. Increased prevalence of CKD was related older age, hypertension, diabetes, or increased body mass index.

AB - Aim: The prevalence of chronic kidney disease (CKD) in the elderly is controversial because age-related decline in kidney function may not truly reflect underlying kidney disease. We estimate the baseline prevalence and predictors of CKD using the CKD Epidemiology Collaboration (CKD-EPI eGFR ) and Berlin Initiative Study 1 (BIS1 eGFR ) eGFR equations in the ASPirin in Reducing Events in the Elderly (ASPREE) trial cohort of healthy older participants. Methods: GFR was estimated using CKD-EPI and BIS1 equations. CKD was defined as eGFR <60 mL/min/1.73 m 2 or ≥ 60 mL/min/1.73 m 2 with urine albumin creatinine ratio (UACR) ≥ 3 mg/mmol. Logistic regression was used to identify predictors of CKD prevalence defined by each eGFR equation. Results: Data for analysis were complete for 17,762 participants. Mean age was 75.1 years (SD 5); 56.4% were female, 76.4% had hypertension, 9% had diabetes mellitus. Mean CKD-EPI eGFR was 73.0 (SD 14.2), compared with mean BIS1 eGFR of 62.7 (11.4). Median UACR was 0.8 (IQR 0.5, 1.5) mg/mmol. Prevalence of CKD by CKD-EPI eGFR was 27% (predominantly due to normoalbuminuric stage 3a CKD), substantially lower than 47.1% by BIS1 eGFR ; the difference was predominantly driven by reclassification of individuals from G1 and G2 CKD to stage G3a without albuminuria. Increased prevalence of CKD by either equation was related to older age, hypertension, diabetes, or higher body mass index. Conclusions: Prevalence of CKD with CKD-EPI eGFR was 27%, and doubled using the elderly specific BIS1 eGFR , with most participants reclassified from stage 2 to stage 3a. Increased prevalence of CKD was related older age, hypertension, diabetes, or increased body mass index.

KW - albuminuria

KW - chronic kidney disease

KW - elderly

KW - estimated glomerular filtration rate

KW - prevalence

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U2 - 10.1111/nep.13565

DO - 10.1111/nep.13565

M3 - Article

JO - Nephrology

JF - Nephrology

SN - 1320-5358

ER -