Estimating GFR in the oldest old : does it matter what equation we use?
(2011) Age and Ageing — Vol. 40, n° 3, p. 401-105 (2011)
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- Authors
Degryse, Jean-Marie 
- Abstract
- In coming decades, the Western world will face an epidemic of ageing. This forthcoming ‘grey epidemic’ will lead to an explosion of chronic diseases like chronic kidney disease (CKD). CKD is an important public health problem for several reasons. First, the prevalence of CKD is high [1], especially among patients aged 70 years and older [2]. Second, knowledge of the actual glomerular filtration rate (GFR) of a patient has important consequences in terms of medication, as the dosages of many drugs should be adapted according to renal function [3]. Finally, the cost and the burden of renal replacement therapy are high. Measurement of the GFR is the gold standard index of overall kidney function. Several equations derived from endogenous filtration markers were developed to estimate this GFR. However, the most accurate method for estimating GFR, especially in elderly patients, is topic of on-going debate [4]. A recent systematic review [5] showed that the modification of diet in renal disease (MDRD) equation [6] does not differ appreciably from the Cockcroft–Gault equation [7] in terms of the accuracy with which GFR is estimated and that there is limited but promising evidence concerning serum cystatin C level as a biomarker of kidney function in the oldest of the old [8, 9]. In the absence of well-validated equations, a variety of equations are currently used in research as well as in clinical practice to estimate GFR in the elderly. Therefore, this study was designed to determine differences in GFR estimated according to various equations in elderly patients and to investigate the clinical relevance of these differences at an individual patient level.
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Citations
Van Pottelbergh, G., Vaes, B., Morelle, J., Jadoul, M., Wallemacq, P., & Degryse, J.-M. (2011). Estimating GFR in the oldest old : does it matter what equation we use? Age and Ageing, 40(3), 401-105. https://doi.org/10.1093/ageing/afr033 (Original work published 2011)