Department of Renal Medicine, Royal Derby Hospital, Derby, UK.
Nephron Clin Pract. 2011;119(4):c269-76. doi: 10.1159/000329109.
The prevalence of chronic kidney disease (CKD) increases with age, but its significance in older patients is uncertain and is regarded by some as part of 'normal aging'. Moreover, subjects ≥75 years are often excluded from research studies. We therefore undertook a prospective study of patients with CKD stage 3 in primary care to compare the risk profile of older versus younger subjects.
Subjects with an estimated glomerular filtration rate (eGFR) 59-30 ml/min/1.73 m(2) on two measurements were recruited from 32 primary care practices. Medical history and demographic data were obtained and participants underwent clinical assessment as well as urine and serum biochemistry tests.
1,741 participants were recruited: mean age 72.9 ± 9 years; 60% female; 98% white; 17% diabetic. Mean eGFR was 52.5 ± 10 ml/min/1.73 m(2) and 16.9% had albuminuria. Subjects ≥75 years had a significantly lower eGFR than younger subjects and a higher risk profile characterised by greater albuminuria, more arterial stiffness and higher serum uric acid levels.
Older subjects with CKD stage 3 evidenced a higher risk profile for CKD progression and cardiovascular events than younger patients. This implies that CKD is not a benign condition in all elderly patients, but further investigation is required to identify those at greatest risk who may benefit from intervention.
慢性肾脏病（CKD）的患病率随年龄增长而增加，但在老年患者中的意义尚不确定，有些人认为这是“正常衰老”的一部分。此外，研究通常排除≥75 岁的受试者。因此，我们在初级保健中对 CKD 3 期患者进行了一项前瞻性研究，以比较老年和年轻受试者的风险特征。
在 32 个初级保健机构中，招募了两次估计肾小球滤过率（eGFR）为 59-30ml/min/1.73m(2)的患者。收集病史和人口统计学数据，对参与者进行临床评估以及尿液和血清生化检查。
共招募了 1741 名参与者：平均年龄 72.9±9 岁；60%为女性；98%为白人；17%为糖尿病患者。平均 eGFR 为 52.5±10ml/min/1.73m(2)，16.9%有白蛋白尿。≥75 岁的受试者的 eGFR 明显低于年轻受试者，且风险特征更高，表现为白蛋白尿更多、动脉僵硬度更高和血尿酸水平更高。
与年轻患者相比，患有 CKD 3 期的老年患者发生 CKD 进展和心血管事件的风险更高。这意味着 CKD 并非所有老年患者的良性疾病，但需要进一步研究以确定风险最高的患者，他们可能受益于干预。
