Chronic kidney disease in octogenarians

Introduction. Chronic kidney disease (CKD) is a major public health problem in the elderly. However, there are limited data on the prevalence of CKD in those older than 80 years, and its clinical importance. We examined the prevalence of CKD in octogenarians, and the association of CKD with cardiovascular disease (CVD) in Cardiovascular Health Study (CHS) All Stars participants.;Methods. Serum creatinine and serum cystatin C were measured in 1028 CHS All Stars participants. Kidney function was estimated using CKD-Epi and cystatin C equations (eGFREPI and eGFRCYS ) and CKD was defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2. The degree of agreement between the two was assessed using kappa statistics. The primary outcome was prevalent CVD defined by a composite of coronary heart disease, heart failure and stroke. Logistic regression was used to examine the association of CKD, defined by creatinine or cystatin C, with CVD in unadjusted and adjusted analyses.;Results. Mean age was 86 years, 64% were females, 86% were Caucasians, 66% had hypertension and 14% had diabetes. Mean (SD) eGFR EPI and eGFRCYS were 58.8 (+ 17) and 61.9 (+ 19.2) mL/min per 1.73 m2, respectively. 527 (51.3%) and 474 (46.1%) participants had CKD using eGFREPI and eGFRCYS, respectively, with moderate agreement between the two (weighted kappa = 0.58, 95% CI 0.53 - 0.62). The prevalence of CVD was 38.5% and both CKDEPI (OR 1.53, 95% CI 1.15 - 2.03) and CKDCYS (OR 1.67, 95% CI 1.25, 2.23) were significantly associated with CVD in adjusted analyses with an incremental association of CVD with lower level of kidney function.;Conclusion. Defined using either creatinine or cystatin C, CKD is highly prevalent in octogenarians and was independently associated with CVD.