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The Chronic Kidney Disease in Elderly Population

Article information

J Korean Med Assoc. 2007;50(6):549-555
Publication date (electronic) : 2009 June 30
doi : https://doi.org/10.5124/jkma.2007.50.6.549
Ho Jun Chin, MD
Department of Internal Medicine, Seoul National University College of Medicine, Korea. mednep@snubh.org

Abstract

Chronic kidney disease (CKD) is an important problem in the elderly as well as in general population. The CKD is defined either by a glomerular filtration rate (GFR) of less than 60 ml/min/1.73m2 BSA or by the presence of kidney damage, assessed most commonly by the finding of albuminuria for three or more consecutive months. The severity of CKD can be classified as follows : stage 1, kidney damage with a normal or increased GFR (more than 90ml/min/1.73m2 BSA); stage 2, kidney damage with a mild decrease in GFR (89 to 60ml/min/1.73m2 BSA) ; stage 3, a moderate decrease in GFR (59 to 30ml/min/1.73m2 BSA); stage 4, a severe decrease in GFR (15 to 29ml/min/1.73m2 BSA); stage 5, kidney failure (i.e., a GFR of less than 15 ml/min/1.73m2 or conditions requiring dialysis). The CKD in elderly population is closely related with a high risk of cardiovascular disease, cognitive impairment, functional limitation, and death. We now have to assess the risk among the elderly patients with CKD for the prevention of morbidity and mortality. Clinicians should measure albuminuria and estimate GFR from serum creatinine to detect CKD. Patients with CKD should be evaluated appropriately and treated according to the underlying cause of CKD. Moreover, the medical society should make an effort to inform individuals with increased risk to develop CKD and the necessity of simple diagnostic tests for CKD.

Keywords: Chronic kidney disease; Elderly; Early diagnosis

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Copyright © 2007 Korean Medical Association

Table 1

Classification, prevalence, and clinical plan of action for stages of chronic kidney disease*

Table 1

*: Chronic kidney disease is defined by either kidney damage or a GFR of less than 60 ml/min/1.73m2 of body surface area for three months or more. Kidney damage is defined by pathological abnormalities or markers of damage, including abnormal results of blood or urine tests or imaging studies.

ref. 2: Prevalence of chronic kidney disease and decreased kidney function in the adult US population in Third National Health and Nutrition Examination Survey

†: Unpublished data of 329,581 subjects having health check-up from 39 hospitals in Korea, which were surveyed by the Korean Society of Nephrology in 2007

‡: Risk factors for chronic kidney disease include sociodemographic or clinical factors associated with an increased risk of chronic kidney disease or disease progression, such as, age more than 60 years, hypertension, diabetes mellitus, a family history of chronic kidney disease, autoimmune disease, systemic infections, urinary tract disorders, neoplasia, exposure to nephrotoxic drugs, and recovery form acute renal injury

Table 2

Equations developed to predict the glomerular filtration rate in adults on the basis of the serum creatinine level

Table 2