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Chronic Kidney Disease

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The Epidemiology of Aging

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Abstract

Chronic kidney disease (CKD) is prevalent in 13% of US community-dwelling adults and over 46% of those >70 years of age. Improved recognition of this wide prevalence in the past 10–15 years has produced standardized staging of CKD, a platform for public health education and surveillance, ongoing research, and guidelines for secondary and tertiary prevention. Such measures are necessary in confronting an often subclinical disease that has massive public health consequences. The vast majority of CKD patients are older adults, due in most cases to decades of hypertension, diabetes and obesity. Many challenges remain in confronting the epidemic of CKD in older adults. Certain structural and functional reductions in the kidney are part of normal aging but mimic CKD, making distinction between routine renal senescence and renal pathology difficult. The most common serum markers and medical formulae for assessing renal function are at times inaccurate in older adults. Improved markers and equations are emerging, but are not yet widely available or perfected. The course of CKD, its risk factors and its associated morbidity and mortality risks are also increasingly recognized to diverge in older compared to younger CKD patients. More research and guidelines are needed to improve risk assessment and diagnosis, and to tailor the care of this largest CKD subpopulation.

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Abbreviations

AASK:

African American Study of Kidney Disease

ACCORD:

Action to Control Cardiovascular Risk in Diabetes

ACEI:

Angiotensin-Converting Enzyme Inhibitor

ADVANCE:

The Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation

AKI:

Acute Kidney Injury

ALLHAT:

Antihypertesive and Lipid-Lowering Treatment to Prevent Heart Attack Trial

ARBs:

Angiotensin Receptor Blockers

BLSA:

Baltimore Longitudinal Study of Aging

CKD:

Chronic Kidney Disease

eGFR:

Epidermal Growth Factor Receptor

ESRD:

End Stage Renal Disease

GFR:

Glomerular Filtration Rate

ICD-9:

International Statistical Classification of Diseases and Related Health Problems, Ninth Edition

MDRD:

Modification of Diet in Renal Disease

NHANES:

National Health and Nutrition Examination Survey

NKF-KDOQI:

National Kidney Foundation Kidney Disease Outcomes Quality Initiative

SHARP:

Study of Heart and Renal Protection

SPRINT:

Systolic Blood Pressure Intervention Trial

UKPDS:

UK Prospective Diabetes Study

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Author information

Authors and Affiliations

  1. Renal-Electrolyte Division, University of Pittsburgh School of Medicine, A915 Scaife Hall, 3550 Terrace St, Pittsburgh, PA, 15261, USA

    Stacy Andersen M.D., Ph.D. & Linda Fried M.D., MPH

  2. Renal Section, VA Pittsburgh Healthcare System, University Drive, Mailstop 111F-U, Pittsburgh, PA, 15240, USA

    Linda Fried M.D., MPH

Authors
  1. Stacy Andersen M.D., Ph.D.
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  2. Linda Fried M.D., MPH
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Correspondence to Linda Fried M.D., MPH .

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Editors and Affiliations

  1. , Graduate School of Public Health, University of Pittsburgh, A527 Crabtree Hall, DeSoto Street 130, Pittsburgh, 15261, Pennsylvania, USA

    Anne B. Newman

  2. Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, DeSoto Street, A510 Crabtree 130, Pittsburgh, 15261, Pennsylvania, USA

    Jane A. Cauley

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Andersen, S., Fried, L. (2012). Chronic Kidney Disease. In: Newman, A., Cauley, J. (eds) The Epidemiology of Aging. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5061-6_27

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