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Renal function in community-dwelling frail elderly: comparison between measured and predicted glomerular filtration rate in the elderly and proposal for a new cystatin C-based prediction equation
Örebro University, School of Health and Medical Sciences.ORCID iD: 0000-0002-1592-8835
2008 (English)In: Aging Clinical and Experimental Research, ISSN 1594-0667, Vol. 20, no 3, 216-225 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIMS: There is a great need to evaluate renal function regularly in elderly people. This study aimed at analyzing renal function in stable, community-dwelling elderly people of 75 years and over, to compare measured and predicted glomerular filtration rates (GFR) and to develop an accurate prediction equation for this age group. METHODS: Forty-five ambulatory elderly people in stable health in ordinary living were randomly selected into four age-classes, aged 75-95. Demographic data, personal activities of daily living, continuous drug prescriptions, body composition, blood pressure and blood chemistry were analysed. GFR was measured as Iohexol clearance based on three time-points 3, 4 and 7 hours after Iohexol injection. RESULTS: Mean GFR was well preserved in all four age-classes. The GFR range was 18-83 mL/min and declined with age. The Cockcroft-Gault prediction equation systematically underestimated measured GFR. A new 'GFRA' prediction equation is presented, based on the inverse of serum cystatin C and independent of gender, body surface area, body weight, lean body mass or serum creatinine. The proposed equation underestimated measured GFR with a mean of only 0.1 mL/min, had better precision compared with the Cockcroft-Gault equation, and was evaluated by the method of cross-validation. CONCLUSIONS: GFR exhibits extensive heterogeneity in frail, community-dwelling elderly people. The proposed GFRA was clearly more precise than the Cockcroft-Gault prediction equation in the study group. However, it needs to be validated in a larger population of elderly subjects, including more individuals in stable health with substantially reduced renal function in whom GFR is measured by a reference method with adequate sampling time.

Place, publisher, year, edition, pages
Milano: Editrice Kurtis , 2008. Vol. 20, no 3, 216-225 p.
National Category
Medical and Health Sciences Geriatrics Clinical Medicine
Research subject
Geriatrics
Identifiers
URN: urn:nbn:se:oru:diva-7009PubMedID: 18594189OAI: oai:DiVA.org:oru-7009DiVA: diva2:219912
Available from: 2009-05-28 Created: 2009-05-28 Last updated: 2016-11-21Bibliographically approved

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