![]() A 70-year old individual with an eGFR of 60 ml/min/1.73 m 2 has an eGFR of a healthy 90-year-old thus, the kidney age is 20 years older than the chronological age, and the Kidney age - Chronological age Difference (KCD) score is 90–70 = 20 years. eGFR values below the black line represent eGFR values below that of a healthy living potential kidney donor of the same age, and correspond to a kidney age that exceeds the chronological age. ![]() The black line represents the age-related decline in eGFR from 105 ml/min/1.73 m 2 at age 40 years to 60 ml/min/1.73 m 2 at age 90 years in healthy living potential kidney donors. Scattergram plot of eGFR in relation to age for 3837 SCREEN-HF participants. However, these stepped eGFR criteria may fail to identify individuals with eGFR-related increased risk of death aged 40–64 years with eGFR ≥60 ml/min/1.73 m 2, or aged 65–74 years with eGFR ≥45 ml/min/1.73 m 2, described by Hallan et al. Criteria for the definition of CKD in adults are: (1) signs of kidney damage, most often determined by an elevated urine albumin (or protein)- to-creatinine ratio or (2) reduced kidney function, indicated by glomerular filtration rate (GFR) 65 years (Fig. Trial registrationĬ NCT00400257, NCT00604006, and NCT01581827.Ĭhronic kidney disease (CKD) “is defined as abnormalities of kidney structure or function, present for >3 months, with implications for health”, which include end-stage kidney disease, but predominantly premature mortality and cardiovascular (CV) events. Further studies that include the full age spectrum are required to examine the optimal KCD score cut point that identifies increased risk of death or cardiovascular event, and kidney events, associated with impaired kidney function, and whether the optimal KCD score cut point is similar for men and women. ![]() In this high cardiovascular risk cohort aged ≥60 years, the KCD score provided an age-adapted measure of kidney function that may assist patient education, and KCD20 provided an age-adapted criterion of eGFR-related increased risk of death or cardiovascular event. KCD20 identified individuals who experienced death or cardiovascular event with greater sensitivity than eGFRstep for all participants, and with greater sensitivity than eGFR60 for participants aged 60–69 years, with similar sensitivities for men and women. However, addition of KCD20 or eGFR60, but not eGFRstep, to a cardiovascular risk factor model improved net reclassification and integrated discrimination. Addition of KCD20, eGFRstep or eGFR60 to a cardiovascular risk factor model did not improve area under the curve for identification of individuals who experienced death or cardiovascular event in receiver operating characteristic curve analysis. In proportional hazards analysis, KCD score ≥ 20 years (KCD20) was associated with increased risk of death or cardiovascular event in unadjusted analysis and after adjustment for age, sex and cardiovascular risk factors. We examined the association between death or cardiovascular event and KCD score, age-dependent stepped eGFR criteria (eGFRstep), and eGFR < 60 ml/min/1.73 m 2 (eGFR60) in a community-based high cardiovascular risk cohort of 3837 individuals aged ≥60 (median 70, interquartile range 65, 75) years, followed for a median of 5.6 years. Given the age-related decline in glomerular filtration rate (GFR) in healthy individuals, we examined the association of all-cause death or cardiovascular event with the Kidney age - Chronological age Difference (KCD) score, whereby an individual’s kidney age is estimated from their estimated GFR (eGFR) and the age-dependent eGFR decline reported for healthy living potential kidney donors.
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