Muglia Lucia, Di Dio Michele, Filicetti Elvira, Greco Giada Ida, Volpentesta Mara, Beccacece Alessia, Fabbietti Paolo, Lattanzio Fabrizia, Corsonello Andrea, Gembillo Guido, Santoro Domenico, Soraci Luca
Centre for Biostatistics and Applied Geriatric Clinical Epidemiology, Italian National Research Center on Aging (IRCCS INRCA), Ancona and Cosenza, Italy.
Unit of Urology, Department of Surgery, Annunziata Hospital, Cosenza, Italy.
Front Med (Lausanne). 2024 Jul 11;11:1397160. doi: 10.3389/fmed.2024.1397160. eCollection 2024.
Chronic kidney disease (CKD) in older individuals is a matter of growing concern in the field of public health across the globe. Indeed, prevalence of kidney function impairment increases with advancing age and is often exacerbated by age-induced modifications of kidney function, presence of chronic diseases such as diabetes, hypertension, and cardiovascular disorders, and increased burden related to frailty, cognitive impairment and sarcopenia. Accurate assessment of CKD in older individuals is crucial for timely intervention and management and relies heavily on biomarkers for disease diagnosis and monitoring. However, the interpretation of these biomarkers in older patients may be complex due to interplays between CKD, aging, chronic diseases and geriatric syndromes. Biomarkers such as serum creatinine, estimated glomerular filtration rate (eGFR), and albuminuria can be significantly altered by systemic inflammation, metabolic changes, and medication use commonly seen in this population. To overcome the limitations of traditional biomarkers, several innovative proteins have been investigated as potential, in this review we aimed at consolidating the existing data concerning the geriatric aspects of CKD, describing the challenges and considerations in using traditional and innovative biomarkers to assess CKD in older patients, highlighting the need for integration of the clinical context to improve biomarkers' accuracy.
老年人慢性肾脏病（CKD）是全球公共卫生领域日益关注的问题。事实上，肾功能损害的患病率随年龄增长而增加，且常因年龄导致的肾功能改变、糖尿病、高血压和心血管疾病等慢性疾病的存在，以及与衰弱、认知障碍和肌肉减少症相关的负担增加而加剧。准确评估老年人的CKD对于及时干预和管理至关重要，并且在很大程度上依赖于用于疾病诊断和监测的生物标志物。然而，由于CKD、衰老、慢性疾病和老年综合征之间的相互作用，这些生物标志物在老年患者中的解读可能很复杂。血清肌酐、估算肾小球滤过率（eGFR）和蛋白尿等生物标志物可能会因该人群中常见的全身炎症、代谢变化和药物使用而发生显著改变。为了克服传统生物标志物的局限性，人们研究了几种创新蛋白作为潜在的生物标志物，在本综述中，我们旨在整合关于CKD老年方面的现有数据，描述在使用传统和创新生物标志物评估老年患者CKD时面临的挑战和注意事项，强调需要结合临床背景以提高生物标志物的准确性。
