دورية أكاديمية
Large discordance between creatinine-based and cystatin C-based estimated glomerular filtration rates is associated with falls, hospitalizations, and death in older adults.
| العنوان: | Large discordance between creatinine-based and cystatin C-based estimated glomerular filtration rates is associated with falls, hospitalizations, and death in older adults. |
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| المؤلفون: | Katz-Agranov N; Department of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, MA, USA., Rieu-Werden ML; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA., Thacker A; Center for Aging and Serious Illness, Massachusetts General Hospital, Boston, MA, USA., Lykken JM; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA., Sise ME; Department of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, MA, USA., Shah SJ; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.; Center for Aging and Serious Illness, Massachusetts General Hospital, Boston, MA, USA. |
| المصدر: | Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2024 Aug 15. Date of Electronic Publication: 2024 Aug 15. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101271570 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1555-905X (Electronic) Linking ISSN: 15559041 NLM ISO Abbreviation: Clin J Am Soc Nephrol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2023- : Hagerstown, MD : Wolters Kluwer Health Original Publication: Washington, D.C. : American Society of Nephrology, c2005- |
| مستخلص: | Background: Estimated glomerular filtration rate (eGFR) calculated using creatinine and cystatin C often differ in older adults. We hypothesized that older adults with cystatin-based eGFR (eGFRcys) values significantly lower than creatinine-based eGFR (eGFRcr) values may have higher risk for aging-related adverse outcomes, independent of kidney function. Methods: We conducted a longitudinal cohort study of adults ≥65 years old from the Health and Retirement Study, a cohort of older American adults, to determine the relationship between eGFR discordance and aging-related adverse outcomes. We calculated eGFRcr and eGFRcys using baseline creatinine and cystatin C measurements. A large eGFR discordance was defined as eGFRcys >30% lower than eGFRcr. We assessed four aging-related adverse outcomes over a two-year follow-up: falls, hip fractures, hospitalizations, and death. We fit separate multivariable regression models to determine the association between having a large eGFR discordance and each outcome adjusting for confounders including kidney function. Results: Of 5574 older adults, 1683 (30%) had a large eGFR discordance. Those with a large eGFR discordance were more likely to be older, female, and White. The prevalence of a large eGFR discordance increased with age, from 20% among those 65-69 years to 44% among those 80 years and older. Over a two-year follow-up, there were 305 deaths (5.5%), 2013 falls (39.2%), 69 hip fractures (1.3%), and 1649 hospitalizations (32.2%). In adjusted analyses, large eGFR discordance was associated with a higher hazard ratio for death (HR 1.43, 95% CI 1.12-1.82) and significantly higher odds of falls (odds ratio [OR] 1.32, 95% CI 1.16-1.51) and hospitalizations (OR 1.32, 95% CI 1.15-1.51). A large eGFR discordance was not associated with hip fractures. Conclusion: In a large, nationally representative cohort of older adults, prevalence of eGFR discordance increased with age and was associated with higher risk of falls, hospitalization, and death, independent of kidney function. (Copyright © 2024 by the American Society of Nephrology.) |
| معلومات مُعتمدة: | K76AG074919 United States AG NIA NIH HHS |
| تواريخ الأحداث: | Date Created: 20240815 Latest Revision: 20240815 |
| رمز التحديث: | 20240816 |
| DOI: | 10.2215/CJN.0000000000000523 |
| PMID: | 39146034 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1555-905X |
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| DOI: | 10.2215/CJN.0000000000000523 |