Several observational studies have focused on risk factors for the development of CKD or terminal renal disease 7, 8, 9, 10, 11, 12.
Therefore, risk factors for an increased annual decline of kidney function have major implications for public health in ageing societies. On the other hand the continuous loss of GFR carries the risk that kidney function will become significantly impaired in elderly individuals, if the loss is greater than average. Accordingly, this definition has been challenged recently and it is perhaps not appropriate in the elderly 5, 6. In any case, it is obvious that with the current life expectancy many people will fall below the threshold of 60 ml/min/1.73 m 2 during their lifetime. GFR < 60 ml/min/1.73 m 2 is usually considered as a criterion for chronic kidney disease (CKD) even though additional criteria apply and other definitions have been proposed for epidemiologic studies 3, 4. 1 ml/min/1.73 m 2 per year which is mainly due to the loss of functioning nephrons 1, 2.
Glomerular filtration rate (GFR) is long known to decline beginning in young adulthood. Sensitivity analysis with exclusion of individuals taking diuretics, antihypertensive, antidiabetic, or lipid lowering drugs confirmed these associations. Diastolic blood pressure, serum uric acid and serum albumin were associated with slower GFR decline in multivariable analysis. White blood cell count showed a moderate association with eGFR loss. Aside from albuminuria systolic blood pressure was most strongly associated with faster decline of eGFR followed by echocardiographic evidence of left ventricular diastolic dysfunction and reduced ejection fraction.
We confirmed a median loss of eGFR per year of approx. Association with the decline of estimated GFR (eGFR) was assessed by multivariable regression analysis. We estimated GFR at baseline and after 5 years of follow-up by two different equations. We analyzed factors affecting absolute and relative change of eGFR over a 5 year period in 12,381 participants of the Gutenberg Health Study. Furthermore, the definition of chronic kidney disease based on GFR may not be appropriate for the elderly. Thus, factors affecting loss of GFR have significant public health implications. At 70 years of age > 40 ml/min/m 2 of GFR will be lost. 1 ml/min/m 2 per year beginning in the third decade of life. Scys is the level of standardized serum cystatin C in mg/L Glomerular filtration rate (GFR) declines with age by approx.BUN is the level of blood urea nitrogen in mg/dL.a is a coefficient dependent on sex: 1 for females, 1.076 for males.It is an excellent confirmatory test, too. This test uses both creatinine and cystatin C indicators. Creatinine-Cystatin C-based CKiD equation (2012)
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