Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2006-2-24
pubmed:abstractText
Current National Kidney Foundation Kidney Disease Outcomes Quality Initiative staging criteria for chronic kidney disease (CKD) are intended to apply to all age groups. However, it is unclear whether different levels of estimated GFR (eGFR) have the same prognostic significance in older and younger patients. The study cohort was composed of Department of Veterans Affairs (VA) patients who were aged 18 to 100 yr and had at least one outpatient serum creatinine measurement between October 1, 2001, and September 30, 2002 (n=2583,911). Patients with ESRD were excluded. GFR was estimated using the Modification of Diet in Renal Disease equation using each patient's first outpatient creatinine measurement during the study period. The association of eGFR with survival was measured by age group. Twenty percent of cohort patients had an eGFR<60 ml/min per 1.73 m2, ranging from 3% among 18- to 44-yr-olds to as high as 49% among 85- to 100-yr-olds. Fifty-two percent (n=266,421) of cohort patients with an eGFR<60 ml/min per 1.73 m2 had "very" moderate reductions in eGFR into the 50- to 59-ml/min per 1.73 m2 range. The association of eGFR with mortality was weaker in the elderly than in younger age groups: Whereas severe reductions in eGFR were associated with an increased risk for death in all age groups, "very" moderate reductions in eGFR (50 to 59 ml/min per 1.73 m2) were associated with an increased adjusted risk for death only among patients who were younger than 65 yr. Age-related attenuation of the association of eGFR with mortality was also present among women and black patients. In the clinical setting, mortality risk stratification in elderly patients should not be based on the same eGFR cut points as for younger age groups and would benefit from finer categorization of the 30- to 59-ml/min per 1.73 m2 eGFR group.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
1046-6673
pubmed:author
pubmed:issnType
Print
pubmed:volume
17
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
846-53
pubmed:dateRevised
2007-11-14
pubmed:meshHeading
pubmed-meshheading:16452492-Adolescent, pubmed-meshheading:16452492-Adult, pubmed-meshheading:16452492-Age Factors, pubmed-meshheading:16452492-Aged, pubmed-meshheading:16452492-Aged, 80 and over, pubmed-meshheading:16452492-Cause of Death, pubmed-meshheading:16452492-Cohort Studies, pubmed-meshheading:16452492-Disease Progression, pubmed-meshheading:16452492-Female, pubmed-meshheading:16452492-Glomerular Filtration Rate, pubmed-meshheading:16452492-Humans, pubmed-meshheading:16452492-Kidney Failure, Chronic, pubmed-meshheading:16452492-Kidney Function Tests, pubmed-meshheading:16452492-Male, pubmed-meshheading:16452492-Middle Aged, pubmed-meshheading:16452492-Predictive Value of Tests, pubmed-meshheading:16452492-Reference Values, pubmed-meshheading:16452492-Risk Assessment, pubmed-meshheading:16452492-Severity of Illness Index, pubmed-meshheading:16452492-Survival Analysis, pubmed-meshheading:16452492-United States
pubmed:year
2006
pubmed:articleTitle
Mortality risk stratification in chronic kidney disease: one size for all ages?
pubmed:affiliation
Department of Medicine, University of California San Francisco, VA Medical Center, San Francisco, 111J Nephrology, 4150 Clement Street, San Francisco, CA 94121, USA. ann.o'hare@med.va.gov
pubmed:publicationType
Journal Article, Comparative Study, Research Support, U.S. Gov't, Non-P.H.S., Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural