Prospective study of progression of kidney dysfunction in community-dwelling older adults

Aim: Few prospective studies have assessed renal dysfunction in older persons. We sought to define kidney dysfunction among a community-based cohort of elderly subjects and to determine the factors for its progression.Mehtods: the Epidemiologia do Idoso (EPIDOSO) Study is a prospective study of individuals >= 65 years old (mean 72.6 +/- 0.3), living in the community in the city of São Paulo. the creatinine clearance (CrCl) of 269 individuals of this cohort was estimated during 8 years of follow-up. the rate of decline in CrCl was calculated using linear regression analysis and dividing the group into tertiles of CrCl change.Results: Overall mean change in CrCl was -2.37 +/- 0.23 mL/min per year. Mean age increased with the greatest degree of decline in renal function (71.1 +/- 0.59, 72.5 +/- 0.54 and 74.3 +/- 0.58, for the first, second and third CrCl change tertiles, respectively, P < 0.01). A higher value of baseline CrCl was associated with progressive decline in CrCl (P < 0.01). Diastolic BP was greater in the second versus the first estimated glomerular filtration rate tertile (83 1 vs 80 1 mmHg, P < 0.05). High-density lipoprotein (HDL) cholesterol was inversely associated with CrCl decline (P < 0.05).Conclusion: Progression of kidney dysfunction occurs inmost community-dwelling elderly. Strategies aimed at slowing the progression should be considered for possible risk factors of older age, baseline CrCl, BP and HDL.Universidade Federal de São Paulo, Escola Paulista Med, Div Nephrol, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Prevent Med, BR-04023900 São Paulo, BrazilSW Texas State Univ, Geriatr Sect, Dallas, TX USAUniversidade Federal de São Paulo, Escola Paulista Med, Div Nephrol, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Prevent Med, BR-04023900 São Paulo, BrazilWeb of Scienc