Abstract:
BACKGROUND:In older patients with chronic kidney disease (CKD), the risk of progression to end stage renal disease and cardiovascular death both differ compared to younger patients. This likely reflects differences in case mix and co-morbid burdens. We sought to establish the extent to which age itself is an independent biomarker of adverse outcome in CKD. METHODS:This was an analysis of the Salford Kidney Study, a prospective, longitudinal, observational study of 2,667 patients with eGFR < 60 ml/min/1.73 m2. Patients were divided into four age groups (< 55, 55-65, 65-75 and > 75 years). Within group adjusted hazard ratios for death in older compared to younger patients were calculated for different primary renal diseases. A competing risk model of death and renal replacement therapy (RRT) as outcomes was performed. RESULTS:The median age of the cohort was 67.1 years [interquartile range (IQR): 55.6-75.3] and median eGFR 30.8 ml/min/1.73 m2 (IQR: 20.6-43.2). Follow up was 3.5 ± 2.9 years. Overall, the adjusted HR for death in patients aged > 75 years compared to those < 55 years was 4.4 (95% CI 3.4-5.9), p < 0.001. The HR for death differed between primary renal diseases and CKD stages. In diabetic nephropathy, the HR was 3.0 (1.8-5.3, p < 0.001), in glomerulonephritis the HR was 12.2 (5.6-25.5, p < 0.001). The cumulative incidence of RRT was < 0.1 at 10 years for patients > 75 years, compared with 0.50 in those < 55 years. Death was more likely at 20 months in those aged 75 years or older (0.17) than at 10 years in those aged < 55 years (0.10). CONCLUSION:This study demonstrates that the risk associated with older age shows significant variability between primary renal diseases. This is whilst acknowledging that observational studies carry the risk of hidden bias not adjusted for in the statistical model.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Raman M,Green D,Middleton RJ,Kalra PAdoi
10.1007/s40620-018-0529-8subject
Has Abstractpub_date
2018-12-01 00:00:00pages
931-939issue
6eissn
1121-8428issn
1724-6059pii
10.1007/s40620-018-0529-8journal_volume
31pub_type
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abstract::Preemptive isolated liver transplantation (PLTX) can cure the metabolic defect in primary hyperoxaluria type 1 (PH1) but there are no uniformally accepted recommendations concerning the timing of this transplantation procedure. We have performed PLTX successfully in 4 children (age 3-9 years) with PH1 with no mortalit...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
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journal_title:Journal of nephrology
pub_type: 杂志文章
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更新日期:2008-03-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2010-05-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2007-03-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2003-03-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/jn.5000146
更新日期:2012-11-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
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更新日期:2013-03-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2012-09-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2005-03-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.5301/JN.2011.7767
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Reduced bone mineral density (BMD) is common in end-stage renal disease (ESRD) patients and predicts outcomes. The chronic kidney disease-mineral bone disorder contributes to low BMD in ESRD; however, the impact of classical risk factors for osteoporosis in the general population, such as body weight and fat...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000185
更新日期:2013-05-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2004-03-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,多中心研究
doi:10.5301/jn.5000071
更新日期:2012-09-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2000-01-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-11-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2009-11-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.5301/jn.5000193
更新日期:2013-07-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-018-0552-9
更新日期:2019-08-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-016-0265-x
更新日期:2016-08-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:
更新日期:2008-11-01 00:00:00
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pub_type: 杂志文章,评审
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