CKD: A Call for an Age-Adapted Definition

Pierre Delanaye*, Kitty J. Jager, Arend Bokenkamp, Anders Christensson, Laurence Dubourg, Bjorn Odvar Eriksen, Francois Gaillard, Giovanni Gambaro, Markus van der Giet, Richard J. Glassock, Olafur S. Indridason, Marco van Londen, Christophe Mariat, Toralf Melsom, Olivier Moranne, Gunnar Nordin, Runolfur Palsson, Hans Pottel, Andrew D. Rule, Elke SchaeffnerMaarten W. Taal, Christine White, Anders Grubb, Jan A. J. G. van den Brand

*Corresponding author for this work

    Research output: Contribution to journalReview articleAcademicpeer-review

    50 Citations (Scopus)

    Abstract

    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 m(2). 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

    Original languageEnglish
    Pages (from-to)1785-1805
    Number of pages21
    JournalJournal of the American Society of Nephrology
    Volume30
    Issue number10
    DOIs
    Publication statusPublished - Oct-2019

    Keywords

    • CHRONIC KIDNEY-DISEASE
    • GLOMERULAR-FILTRATION-RATE
    • STAGE RENAL-DISEASE
    • ALL-CAUSE MORTALITY
    • COLLABORATIVE METAANALYSIS
    • REFERENCE VALUES
    • ESTIMATED GFR
    • CARDIOVASCULAR MORTALITY
    • HIGHER ALBUMINURIA
    • ELDERLY POPULATION

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