Glomerular Filtration Rate in Older Adults


Glomerular Filtration Rate in Older Adults

The global life expectancy increase has paralleled with an increase in the number of CKD cases . Serum creatinine has been widely used to assess renal function. However, the creatinine production rate is low in elderly people due to the muscle mass decrease related to age. Therefore, the serum creatinine might not be a satisfactory parameter for the renal function assessment in the elderly.

Equations to estimate glomerular filtration rate (GFR) are a more reliable and accurate method to assess the renal function. The most widely used in clinical practice are the Modification of Diet in Renal Disease (MDRD) and the Cockcroft-Gault (CG) equations . However, the CG equation may underestimate the actual GFR, especially in individuals older than 79 years  and the MDRD equation underestimates the GFR in patients with a GFR>60 mL/min/1.73 m2 .

The Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) equation that is based on creatinine (CKD-EPI creatinine) has been suggested recently as a more accurate alternative to the MDRD equation, especially when the GFR is >60 mL/min/1.73 m2. Furthermore, two equations were subsequently developed: the CDK-EPI cystatin equation, which is based on the cystatin C and the CDK-EPI creatinine-cystatin equation, which uses both parameters.

Cystatin C is a well-known marker of the renal function and recently it has been considered to be an alternative marker for the renal function in elderly adults since it does not seem to be influenced by age, muscle mass or nutritional status. Our previous studies with iohexol clearance used as gold standard have indicated that cystatin C might be useful for the renal function assessment in elderly adults.

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Contact details

Alex Stewart
Managing Editor
Journal of Nephrology and Urology