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CKD : A Call for an...
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Delanaye, PierreUniversity of Liège
(author)
CKD : A Call for an Age-Adapted Definition
- Article/chapterEnglish2019
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LIBRIS-ID:oai:lup.lub.lu.se:121c4fab-96ff-4651-8d5f-a8c97bdd0e7b
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https://lup.lub.lu.se/record/121c4fab-96ff-4651-8d5f-a8c97bdd0e7bURI
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https://doi.org/10.1681/ASN.2019030238DOI
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Language:English
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Summary in:English
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Subject category:for swepub-publicationtype
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Subject category:ref swepub-contenttype
Notes
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Current criteria for the diagnosis of CKD in adults include persistent signs of kidney damage, such as increased urine albumin-to-creatinine ratio or a GFR below the threshold of 60 ml/min per 1.73 m2 This threshold has important caveats because it does not separate kidney disease from kidney aging, and therefore does not hold for all ages. In an extensive review of the literature, we found that GFR declines with healthy aging without any overt signs of compensation (such as elevated single-nephron GFR) or kidney damage. Older living kidney donors, who are carefully selected based on good health, have a lower predonation GFR compared with younger donors. Furthermore, the results from the large meta-analyses conducted by the CKD Prognosis Consortium and from numerous other studies indicate that the GFR threshold above which the risk of mortality is increased is not consistent across all ages. Among younger persons, mortality is increased at GFR <75 ml/min per 1.73 m2, whereas in elderly people it is increased at levels <45 ml/min per 1.73 m2 Therefore, we suggest that amending the CKD definition to include age-specific thresholds for GFR. The implications of an updated definition are far reaching. Having fewer healthy elderly individuals diagnosed with CKD could help reduce inappropriate care and its associated adverse effects. Global prevalence estimates for CKD would be substantially reduced. Also, using an age-specific threshold for younger persons might lead to earlier identification of CKD onset for such individuals, at a point when progressive kidney damage may still be preventable.
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Jager, Kitty JUniversity of Amsterdam
(author)
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Bökenkamp, ArendVrije Universiteit Amsterdam
(author)
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Christensson, AndersLund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)medf-ach
(author)
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Dubourg, LaurenceHôpital Edouard Herriot
(author)
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Eriksen, Bjørn OdvarUiT The Arctic University of Norway, Tromsø
(author)
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Gaillard, FrançoisUniversity of Paris-Saclay
(author)
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Gambaro, GiovanniUniversity of Verona
(author)
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van der Giet, MarkusCharité - University Medicine Berlin
(author)
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Glassock, Richard JCalifornia State University, Los Angeles
(author)
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Indridason, Olafur SNational University Hospital of Iceland
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van Londen, MarcoUniversity Medical Center Groningen
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Mariat, Christophe
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Melsom, Toralf
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Moranne, Olivier
(author)
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Nordin, Gunnar
(author)
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Palsson, Runolfur
(author)
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Pottel, Hans
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Rule, Andrew D
(author)
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Schaeffner, Elke
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Taal, Maarten W
(author)
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White, Christine
(author)
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Grubb, AndersLund University,Lunds universitet,Avdelningen för klinisk kemi och farmakologi,Institutionen för laboratoriemedicin,Medicinska fakulteten,Cystatin C, njursjukdom, amyloidos och antibiotika,Forskargrupper vid Lunds universitet,Division of Clinical Chemistry and Pharmacology,Department of Laboratory Medicine,Faculty of Medicine,Cystatin C, renal disease, amyloidosis and antibiotics,Lund University Research Groups,Skåne University Hospital(Swepub:lu)kkem-agr
(author)
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van den Brand, Jan A J G
(author)
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University of LiègeUniversity of Amsterdam
(creator_code:org_t)
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In:Journal of the American Society of Nephrology30:10, s. 1785-18051046-6673
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Delanaye, Pierre
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Jager, Kitty J
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Bökenkamp, Arend
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Christensson, An ...
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Dubourg, Laurenc ...
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Eriksen, Bjørn O ...
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Gaillard, Franço ...
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Gambaro, Giovann ...
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van der Giet, Ma ...
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Glassock, Richar ...
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Indridason, Olaf ...
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van Londen, Marc ...
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Mariat, Christop ...
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Melsom, Toralf
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Moranne, Olivier
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Nordin, Gunnar
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Palsson, Runolfu ...
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Pottel, Hans
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Rule, Andrew D
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Schaeffner, Elke
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Taal, Maarten W
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White, Christine
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Grubb, Anders
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van den Brand, J ...
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