CHICAGO—In a large, collaborative study that included more than 2 million individuals from around the world, two measures of poor kidney function, low estimated glomerular filtration rate and high albuminuria, were associated with risk of death and end-stage renal disease regardless of the age of the individuals, according to a study appearing in The Journal of the American Medical Association (JAMA). The study is being release early online to coincide with its presentation at the American Society of Nephrology’s (ASN) Kidney Week meeting.
“Chronic kidney disease (CKD) is defined by reduced glomerular filtration rate [GFR less than 60 mL/min/1.73 m2] or kidney damage (usually detected by high albuminuria; e.g., 30 mg or greater of albumin per 1 gram of creatinine). Chronic kidney disease affects 10 percent to 15 percent of adults in the United States, Europe, and Asia, and the prevalence increases dramatically with age (from 4 percent at age 20-39 to 47 percent at age ≥70 years in the United States). Recently, it has been suggested that the definition and staging of CKD and corresponding clinical risk should be determined by the combination of estimated GFR (eGFR) and albuminuria levels,” according to background information in the article. “However, controversy exists about whether age modifies their independent and combined association with clinical risk, partly because of different analytic approaches. The resulting uncertainty about the comprehensive effect of age on the CKD-risk relationship hampers optimal clinical practice and public health initiatives for this large patient group.”
Stein I. Hallan, MD, PhD, of the Norwegian University of Science and Technology, Trondheim, Norway, and colleagues conducted a study to evaluate the possible effect of age on the association of eGFR and albuminuria with risk of death and end-stage renal disease (ESRD), examining both relative and absolute risks. The study included 2,051,244 participants from 33 general population or high-risk (of vascular disease) cohorts and 13 CKD groups from Asia, Australasia, Europe, and North/South America, conducted from 1972-2011, with an average follow-up time of 5.8 years.