Journal
NEPHROLOGY
Volume 13, Issue 2, Pages 99-103Publisher
BLACKWELL PUBLISHING
DOI: 10.1111/j.1440-1797.2008.00919.x
Keywords
chronic kidney disease; creatinine clearance; elderly; high-density lipoprotein
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Aim: Few prospective studies have assessed renal dysfunction in older persons. We sought to define kidney dysfunction among a community-based cohort of elderly subjects and to determine the factors for its progression. Mehtods: The Epidemiologia do Idoso (EPIDOSO) Study is a prospective study of individuals >= 65 years old (mean 72.6 +/- 0.3), living in the community in the city of Sao Paulo. The creatinine clearance (CrCl) of 269 individuals of this cohort was estimated during 8 years of follow-up. The rate of decline in CrCl was calculated using linear regression analysis and dividing the group into tertiles of CrCl change. Results: Overall mean change in CrCl was -2.37 +/- 0.23 mL/min per year. Mean age increased with the greatest degree of decline in renal function (71.1 +/- 0.59, 72.5 +/- 0.54 and 74.3 +/- 0.58, for the first, second and third CrCl change tertiles, respectively, P < 0.01). A higher value of baseline CrCl was associated with progressive decline in CrCl (P < 0.01). Diastolic BP was greater in the second versus the first estimated glomerular filtration rate tertile (83 1 vs 80 1 mmHg, P < 0.05). High-density lipoprotein (HDL) cholesterol was inversely associated with CrCl decline (P < 0.05). Conclusion: Progression of kidney dysfunction occurs inmost community-dwelling elderly. Strategies aimed at slowing the progression should be considered for possible risk factors of older age, baseline CrCl, BP and HDL.
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