With an increase in the elderly population, the frequency of hospitalizations in recent years has also risen at a rapid pace. This, in turn, has resulted in poor outcomes and costly treatments. Hospitalization rates increase in elderly patients due to a decline in glomerular filtration rate (GFR).

To investigate the connection between GFR and comorbidity and reasons for hospitalization in elderly patients.

We analyzed patients aged 75 years and over who were admitted to the internal medicine clinic of a tertiary hospital in Eskisehir. At admission, we calculated GFR values using the Modification of Diet in Renal Disease study formula and classified them into six categories: G1, G2, G3a, G3b, G4, and G5. We analyzed associations with hospitalization diagnoses and comorbidity factors.

The average age of the patients was 80.8 years (± 4.5 years). GFR was 57.287 ± 29.5 mL/kg/1.73 m² in women and 61.3 ± 31.5 mL/kg/1.73 m² in men (P = 0.106). Most patients were admitted to the hospital at G2 stage (32.8%). The main reasons for hospitalization were anemia (34.4% and 28.6%) and malnutrition (20.9% and 20.8%) in women and men, respectively (P = 0.078). The most frequent comorbidity leading to hospitalization was arterial hypertension (n = 168, 28%), followed by diabetes (n = 166, 27.7%) (P = 0.001).

When evaluating geriatric patients, low GFR alone does not provide sufficient information. Patients’ comorbid factors should also be taken into account. There is no association between low GFR during hospitalization and hospitalization-related diagnoses. Knowing the GFR value before hospitalization will be more informative in such studies.

• Aging
• Glomerular filtration rate
• Hospitalization
• Comorbidity
• Elderly hospitalizations

• Chronic kidney disease
• Healthcare costs
• Multicentre
• Older people
• Resources consumption

• Humans
• Aged
• Male
• Female
• Health Care Costs/statistics & numerical data
• Renal Insufficiency, Chronic/economics
• Renal Insufficiency, Chronic/epidemiology
• Aged, 80 and over
• Prospective Studies
• Europe/epidemiology
• Glomerular Filtration Rate
• Hospitalization/economics
• Hospitalization/statistics & numerical data
• Cost of Illness

• 634869 Horizon 2020 ()

• Albuminuria
• CKD
• KDIGO
• SPRINT trial
• cardiovascular events

• K24 DK092290 NIDDK NIH HHS

• Humans
• Kidney/diagnostic imaging
• Renal Insufficiency, Chronic
• Aging

• clinical epidemiology
• epidemiology and outcomes
• histopathology
• kidney biopsy
• renal pathology
• ckd non-dialysis

• Adult
• Humans
• Aged
• Nephrosclerosis/pathology
• Prognosis
• Kidney/pathology
• Nephrectomy
• Biopsy
• Renal Insufficiency, Chronic/pathology
• Fibrosis
• Atrophy/pathology

• R01 DK090358 NIDDK NIH HHS

• Arteriovenous fistula (AVF)
• central venous catheter (CVC)
• decisional influences
• dialysis initiation
• end-stage renal disease (ESRD)
• hemodialysis
• individualized care
• patient-centered care
• qualitative research
• shared decision-making (SDM)
• unplanned dialysis start
• vascular access

• Kidney Failure Risk Equation
• age-adapted diagnosis and referral of CKD
• chronic kidney disease
• nephrology referral

• CKD
• DDT exposure
• Kidney function tests
• NHANES
• Pesticide

• Adult
• Biphenyl Compounds
• DDT
• Environmental Pollutants
• Humans
• Insecticides/analysis
• Organophosphates
• Organophosphorus Compounds
• Pesticides/adverse effects
• Pesticides/analysis
• Renal Insufficiency, Chronic/chemically induced
• Renal Insufficiency, Chronic/epidemiology
• Trichloroethanes/analysis

• age
• chronic kidney disease
• kidney failure
• mortality
• risk

In the last decades, improvements in the average life expectancy in the world population have been associated with a significant increase in the proportion of elderly people, in parallel with a higher prevalence of non-communicable diseases, such as hypertension and diabetes. As the kidney is a common target organ of a variety of diseases, an adequate evaluation of renal function in the approach of this population is of special relevance. It is also known that the kidneys undergo aging-related changes expressed by a decline in the glomerular filtration rate (GFR), reflecting the loss of kidney function, either by a natural senescence process associated with healthy aging or by the length of exposure to diseases with potential kidney damage. Accurate assessment of renal function in the older population is of particular importance to evaluate the degree of kidney function loss, enabling tailored therapeutic interventions. The present review addresses a relevant topic, which is the effects of aging on renal function. In order to do that, we analyze and discuss age-related structural and functional changes. The text also examines the different options for evaluating GFR, from the use of direct methods to the implementation of several estimating equations. Finally, this manuscript supports clinicians in the interpretation of GFR changes associated with age and the management of the older patients with decreased kidney function.

Kidney function declines naturally with advancing age. Therefore an age-adapted estimated glomerular filtration rate (eGFR) threshold has been proposed instead of the fixed threshold for CKD definition. This study aims to describe and compare the profile of CKD patients defined by these two criteria in a Chinese population.

We recruited adult participants with selected biochemical tests from the Chinese Physiological Constant and Health Condition survey conducted from 2007 to 2011, with the GFR estimated by the Chronic Kidney Disease Epidemiology Collaboration formula. The age-adapted threshold of eGFR is 75, 60 and 45 ml/min/1.73 m² for the population <40 years of age, 40–64 years and >64 years, respectively. The fixed threshold is 60 ml/min/1.73 m² for all ages.

Among the recruited 23 438 participants, 480 were diagnosed with CKD by fixed threshold criteria, while 391 were diagnosed with CKD by age-adapted criteria. Patients diagnosed by fixed threshold criteria were significantly older (66.4 versus 43.4 years; P < .001) and had a higher prevalence of all CVD risk factors compared with the non-CKD population. In contrast, age-adapted criteria defined a younger patient group and were not significantly associated with diabetes or obesity. When adjusted by age and gender, fixed threshold–defined CKD was not significantly associated with the number of coexisting CVD risk factors, while age-adapted-defined CKD was significantly associated. We also found that the CKD patients defined by age-adapted criteria matched well with the 2.5th percentile of eGFR in Chinese individuals. When compared with their age- and gender-matched controls, patients included by age-adapted criteria but excluded by fixed threshold criteria had a significantly higher prevalence of hypertension (23.2% versus 7.7%; P < .001) and hyperuricaemia (25.0% versus 5.5%; P < .001), while patients included only by the fixed threshold criteria were not significantly different in the prevalence of CVD risk factors and CKD-related disturbance except for hyperuricaemia (41.2% versus 14.0%; P < .001).

An age-adapted criterion is more closely associated with CVD risk factors and CKD-related diseases compared with fixed threshold criteria.

• Aging
• Chronic kidney disease
• Expression profiling

• Aged
• Animals
• Endothelial Cells/metabolism
• Glomerulosclerosis, Focal Segmental/genetics
• Glomerulosclerosis, Focal Segmental/metabolism
• Humans
• Kidney Glomerulus/metabolism
• Mice
• Podocytes/metabolism
• Signal Transduction

• R01 AG046231 NIA NIH HHS
• R01 DK097598 NIDDK NIH HHS
• UC2 DK126006 NIDDK NIH HHS
• R01 DK123031 NIDDK NIH HHS
• R01 DK128204 NIDDK NIH HHS

• aging
• kidney anatomy
• kidney function
• glomerular filtration rate
• chronic kidney disease

• Aging
• Female
• Glomerular Filtration Rate
• Humans
• Kidney
• Male
• Podocytes
• Renal Insufficiency, Chronic/diagnosis

• R01 DK090358 NIDDK NIH HHS