Older patients are less prone to fast decline of renal function: a propensity-matched study

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorPINA, Paula M. R.
dc.contributor.authorARCON, Luis Carlos
dc.contributor.authorZATZ, Roberto
dc.contributor.authorMOYSES, Rosa M. A.
dc.contributor.authorELIAS, Rosilene M.
dc.date.accessioned2023-12-15T18:44:35Z
dc.date.available2023-12-15T18:44:35Z
dc.date.issued2023
dc.description.abstractPurposeDespite CKD is common among older patients, and although factors associated with CKD progression have been explored over decades, little is known about the decline of renal function specifically in older individuals.MethodsWe included adult patients with CKD on conservative management in a propensity-score matched study 1:1 older (> 65 year) and young (<= 65 yr). Factors associated with the slope of the decline of eGFR such as proteinuria, initial eGFR, diabetes, sex, and use of angiotensin-converting enzyme inhibitor/angiotensin receptor block (ACEI/ARB) were analyzed. Inclusion criteria were at least two consultations in the service and an initial eGFR lower than 45 ml/min/m(2), in the period between January 2012 and December 2017.ResultsCrude analysis of eGFR decline shows a slower progression of older patients when compared to younger patients in both absolute change [- 2.0 (- 4.5, - 1.0) vs. -3.0 (- 7.0, - 1.0) ml/min/1.73m(2), p < 0.001] and slope of eGFR reduction [- 2.2 (- 4.4, - 1.0) vs. 3.1 (- 6.7, - 1.2)) ml/min/1.73m(2), p < 0.001]. Patients considered fast progressors (> 5 ml/min/1.73 m(2)/year decline in eGFR) were less likely to be older (35.2% young vs. 22.0% older, p < 0.001). Adjusted logistic multivariate regression confirmed that older patients had less odds ratio of eGFR decline, independently of the presence of proteinuria, diabetes, ACEI/ARB use, sex, baseline eGFR, baseline phosphate and baseline 25(OH) vitamin D.ConclusionOlder patients present slower CKD progression even after multiple adjustments. This information should be taken into consideration while treating these patients on conservative management and should be kept in mind while planning dialysis start.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationINTERNATIONAL UROLOGY AND NEPHROLOGY, v.55, n.12, p.3245-3252, 2023
dc.identifier.doi10.1007/s11255-023-03610-4
dc.identifier.eissn1573-2584
dc.identifier.issn0301-1623
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/57316
dc.language.isoeng
dc.publisherSPRINGEReng
dc.relation.ispartofInternational Urology and Nephrology
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright SPRINGEReng
dc.subjectOldereng
dc.subjectChronic kidney diseaseeng
dc.subjectDiabeteseng
dc.subjectDisease progressioneng
dc.subjectProteinuriaeng
dc.subject.otherchronic kidney-diseaseeng
dc.subject.otherdiabetic-nephropathyeng
dc.subject.otherdouble-blindeng
dc.subject.othersystemeng
dc.subject.otherproteinuriaeng
dc.subject.otherprogressioneng
dc.subject.otherinhibitioneng
dc.subject.otheroutcomeseng
dc.subject.othertherapyeng
dc.subject.othergendereng
dc.subject.wosUrology & Nephrologyeng
dc.titleOlder patients are less prone to fast decline of renal function: a propensity-matched studyeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcPAULA MIONETE RIBEIRO PINA
hcfmusp.contributor.author-fmusphcLUIS CARLOS ARCON
hcfmusp.contributor.author-fmusphcROBERTO ZATZ
hcfmusp.contributor.author-fmusphcROSA MARIA AFFONSO MOYSES
hcfmusp.contributor.author-fmusphcROSILENE MOTTA ELIAS
hcfmusp.description.beginpage3245
hcfmusp.description.endpage3252
hcfmusp.description.issue12
hcfmusp.description.volume55
hcfmusp.origemWOS
hcfmusp.origem.pubmed37160835
hcfmusp.origem.scopus2-s2.0-85158942885
hcfmusp.origem.wosWOS:000984774900002
hcfmusp.publisher.cityDORDRECHTeng
hcfmusp.publisher.countryNETHERLANDSeng
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