Garasto Sabrina, Fusco Sergio, Corica Francesco, Rosignuolo Maria, Marino Antonio, Montesanto Alberto, De Rango Francesco, Maggio Marcello, Mari Vincenzo, Corsonello Andrea, Lattanzio Fabrizia
Unit of Geriatric Pharmacoepidemiology, Italian National Research Center on Aging (INRCA), C. da Muoio Piccolo, 87100 Cosenza, Italy.
Unit of Geriatric Pharmacoepidemiology, Italian National Research Center on Aging (INRCA), C. da Muoio Piccolo, 87100 Cosenza, Italy ; Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy.
Biomed Res Int. 2014;2014:916542. doi: 10.1155/2014/916542. Epub 2014 Mar 20.
We aimed at reviewing age-related changes in kidney structure and function, methods for estimating kidney function, and impact of reduced kidney function on geriatric outcomes, as well as the reliability and applicability of equations for estimating glomerular filtration rate (eGFR) in older patients. CKD is associated with different comorbidities and adverse outcomes such as disability and premature death in older populations. Creatinine clearance and other methods for estimating kidney function are not easy to apply in older subjects. Thus, an accurate and reliable method for calculating eGFR would be highly desirable for early detection and management of CKD in this vulnerable population. Equations based on serum creatinine, age, race, and gender have been widely used. However, these equations have their own limitations, and no equation seems better than the other ones in older people. New equations specifically developed for use in older populations, especially those based on serum cystatin C, hold promises. However, further studies are needed to definitely accept them as the reference method to estimate kidney function in older patients in the clinical setting.
我们旨在综述肾脏结构和功能的年龄相关变化、估算肾功能的方法、肾功能降低对老年患者预后的影响,以及估算老年患者肾小球滤过率(eGFR)的方程的可靠性和适用性。慢性肾脏病(CKD)与老年人群中的不同合并症及不良预后相关,如残疾和过早死亡。肌酐清除率及其他估算肾功能的方法在老年受试者中不易应用。因此,对于在这一脆弱人群中早期发现和管理CKD而言,一种准确可靠的计算eGFR的方法将非常必要。基于血清肌酐、年龄、种族和性别的方程已被广泛使用。然而,这些方程有其自身的局限性,在老年人中似乎没有一个方程比其他方程更好。专门为老年人群开发的新方程,尤其是基于血清胱抑素C的方程,具有前景。然而,需要进一步研究以明确将其作为临床环境中估算老年患者肾功能的参考方法。