Expert Forum
Study on changes in the glomerular filtration rate with aging and their influencing factors
Zhang Juan, Wei Lu, Zhang Yu, Pei Xiaohua, Bai Yun, Yong Zhenzhu, Shen Xue, Zhang Qun, Zhao Weihong
Published 2021-10-14
Cite as Chin J Geriatr, 2021, 40(10): 1250-1254. DOI: 10.3760/cma.j.issn.0254-9026.2021.10.007
Abstract
ObjectiveTo evaluate changes in the estimate glomerular filtration rate(eGFR)with aging and the risk factors.
MethodsA retrospective cross-sectional study was performed based on people receiving physical examinations at the First Affiliated Hospital of Nanjing Medical University from January 2017 to January 2018.Subjects were divided into seven subgroups according to age: 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, and ≥80 years old.eGFR was estimated by the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPIScr)equation.Multivariate linear regression was used to analyze the correlation between eGFR and the influencing variables.The chi-square test was used to compare the incidences of eGFR<60 ml·min-1·1.73m-2in different age groups.
ResultsA total of 33 824 participants were included in this study.There was a negative linear eGFR-age correlation in the subjects.The mean annual rate of decline in eGFR was 0.83 ml·min-1·1.73m-2.Furthermore, the decline was steady and accelerated from the third and seventh decade onward(F=9.51, 5.37, both P=0.000). Multiple linear regression analysis showed that aging was the most prominent factor(β=-0.604, -0.534, both P=0.000), followed by serum uric acid(BUA)(β=-0.270, -0.280, both P=0.000), fasting blood-glucose(FBG)(β=-0.064, -0.046, both P=0.000), systolic blood pressure(SBP)(β=-0.015, -0.028, both P<0.05), and diastolic blood pressure(DBP)(β=-0.010, -0.026, both P<0.05). In non-elderly subjects, eGFR was found to have negative associations with body mass index(BMI)and albumin(ALB)(β=-0.028, -0.047, all P=0.000). However, in the elderly, eGFR was positively associated with ALB(β=0.022, P=0.031). eGFR showed no statistically significant correlation with BMI, TC and LDL-C.The prevalence of eGFR<60 ml·min-1·1.73m-2increased with age, at 1.55%(523/33 824)for all subjects, of whom 73.80%(386/523)were aged over 60.The incidence obviously increased from 0.22%(14/6 453)for aged 18-29 to 22.57%(214/948)for aged 80 and above(χ2=2433.71, P=0.000).
ConclusionseGFR decreases significantly with age.The incidence of eGFR<60 ml·min-1·1.73m-2in the elderly is high; eGFR is significantly correlated with BUA, FBG, SBP, DBP, and ALB in the elderly.
Key words:
Glomerular filtration rate; Risk factors
Contributor Information
Zhang Juan
Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Wei Lu
Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Zhang Yu
Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Pei Xiaohua
Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Bai Yun
Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Yong Zhenzhu
Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Shen Xue
Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Zhang Qun
Health Management Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
Zhao Weihong
Division of Nephrology, Department of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
