Key result
Age-adapted CKD criteria identify patients missed by fixed thresholds who have ~3-fold higher hypertension prevalence.
Why the study?
Kidney function declines with age, prompting evaluation of age-adapted versus fixed eGFR thresholds for CKD definition in a Chinese population.
Does an age-adapted eGFR threshold better identify patients with CVD risk factors compared to a fixed threshold in a Chinese population?
Cross-Sectional (n=23,438)
Yes
Does an age-adapted eGFR threshold better identify patients with CVD risk factors compared to a fixed threshold in a Chinese population?
An age-adapted eGFR criterion for defining CKD may better identify patients with associated CVD risk factors compared to the traditional fixed threshold.
Answers are grounded in this paper and cite their sources.
May support age-adapted eGFR thresholds to flag hypertension risk; hypothesis-generating for CVD outcomes in Chinese adults.
Background 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. Method 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. Results 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). Conclusion An age-adapted criterion is more closely associated with CVD risk factors and CKD-related diseases compared with fixed threshold criteria.
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Ma et al. (2022) conducted a cross-sectional in Chronic Kidney Disease (n=23,438). Age-adapted eGFR threshold vs. Fixed eGFR threshold was evaluated on Prevalence of hypertension in patients included by age-adapted but excluded by fixed threshold criteria versus matched controls (p=<0.001). Age-adapted CKD criteria identified patients who were excluded by fixed criteria but had a significantly higher prevalence of hypertension (23.2% vs 7.7%; P<0.001) than matched controls.
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