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衰老与肾脏疾病相遇。

Ageing meets kidney disease.

机构信息

Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain.

RICORS2040, Madrid, Spain.

出版信息

Age Ageing. 2022 Aug 2;51(8). doi: 10.1093/ageing/afac157.

Abstract

Chronic kidney disease (CKD) is defined as abnormalities of kidney structure or function, present for >3 months, with implications for health. The most used diagnostic criteria are a urinary albumin: creatinine ratio ≥30 mg/g or an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Either of these diagnostic thresholds is associated with adverse health outcomes. GFR decreases with age and the prevalence of CKD is highest in older adults; moreover, the presence of CKD is associated with an increased risk of all-cause and cardiovascular death related to accelerated ageing in all age ranges, and the absolute increase in risk is highest for those aged >75 years. Indeed, premature death is a more common outcome than CKD progression to kidney failure requiring kidney replacement therapy. The progressive ageing of the world population contributes to the projection that CKD will become the second most common cause of death before the end of the century in countries with long life expectancy. The current collection of selected studies on kidney disease and ageing published in Age&Ageing, NDT and CKJ provides an overview of key topics, including cognitive decline, sarcopaenia, wasting and cardiovascular and non-cardiovascular morbidity and mortality, the management of kidney failure and gender differences in CKD progression.

摘要

慢性肾脏病(CKD)定义为肾脏结构或功能异常,持续时间>3 个月,对健康有影响。最常用的诊断标准是尿白蛋白与肌酐比值≥30mg/g 或估算肾小球滤过率(eGFR)<60mL/min/1.73m2。这两个诊断阈值中的任何一个都与不良健康结局有关。肾小球滤过率随年龄增长而下降,CKD 的患病率在老年人中最高;此外,CKD 的存在与所有年龄段与加速衰老相关的全因和心血管死亡风险增加有关,对于年龄>75 岁的人,风险的绝对增加最高。事实上,与需要肾脏替代治疗的肾衰竭进展相比,过早死亡是更常见的结果。世界人口的老龄化加剧,预计在预期寿命较长的国家,CKD 将在本世纪末成为第二大常见死因。目前在《Age&Ageing》、《NDT》和《CKJ》上发表的关于肾脏疾病和衰老的精选研究集提供了关键主题的概述,包括认知能力下降、肌肉减少症、消瘦和心血管及非心血管发病率和死亡率、肾衰竭的管理以及 CKD 进展中的性别差异。

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