After meta-analysis of the data, the researchers found that mortality (112,325 deaths) and ESRD (8,411 events) risks were higher at lower eGFR and higher albuminuria in every age category.
“We found that mortality risk associations were weaker on the relative scale but stronger on the absolute scale at older ages in general population and high-risk cohorts. In cohorts specifically selected for CKD, age did not modify the mortality associations. For ESRD risk, age did not significantly influence relative and absolute risk gradients. Thus, eGFR and albuminuria were strongly associated with both mortality and ESRD in a wide range of studies across the full age range. Importantly, the results were largely consistent across diverse cohorts in terms of demographic and clinical characteristics.”
The authors add that their findings have several important implications. “First, our study shows that the kidney measures used for defining and staging CKD are strong predictors of clinical risk across the full age range, including age 75 years or older in many cohorts. This contradicts concerns raised by some that current CKD guidelines should be used with caution in older individuals and that low eGFR reflects only natural aging. … Second, our data support the recommendations from several investigators that CKD measures should be added to mortality risk equations. … Third, the strong increase in mortality rate along with kidney measures at older ages suggests that older adults should not be left out from management strategies of CKD.”
“Although some variation in management of CKD should be considered by age based on cost and benefits, with respect to risk of mortality and ESRD, our data support a common definition and staging of CKD based on eGFR and albuminuria for all age groups.”