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Abstrakt
Evaluating Kidney Function in Elderly Population: A Cross-Sectional Study in Primary Health Care
Zoi Tsimtsiou*, Konstantina Karakoula, Elpida Efthymiadou, Antonios Asimakopoulos, Basiliki Fardi, Sofia Birka and Foteini Dantsi
Background: Chronic kidney disease (CKD) is an important condition, with implications in morbidity and mortality that primary care physicians should early detect. The aim of this study was to identify the prevalence of CKD among the elderly population in primary care settings and to investigate the extent to which serum creatinine reflects kidney function.
Methods: All the patients aged 65 years old and over who came for laboratory tests in an urban primary health center for six months were invited to participated. Additional data on their age, gender, body weight (kg) and their medical history on chronic diseases were collected. The Cockcroft-Gault equation was used for the estimation of the participants' kidney function.
Results: 325 patients participated in the study with mean age 73.9 years old (±6.0, min 65-max 91), out of which 146 male (44.9%). According to the estimated creatinine clearance, which in turn estimates glomerular filtration rate (GFR) in ml/min, eGFR: 60-89 was found in 50.5% (164), eGFR: 30-59 in 26.2% (85) and eGFR: 15-29 in 2.2% (7). Spearman's correlation coefficient (rho0 between age and eGFR was -0.52, p<0.001. Serum creatinine (mg/dl) was ranging from 0.7 to 1.7 (mean 1.1) in patients with eGFR: 30 ml/min to 59 ml/min and 1.6 to 3.2 (mean 2.1) in the group with eGFR: 15 ml/min to 29 ml/min.
Conclusion: General practitioners should routinely estimate kidney function in their in the older patients. Since the normal serum creatinine reference interval does not necessarily reflect a normal kidney function, GFR equations may facilitate its estimation in every day practice. Early identification of CKD, dosage reduction of renally excreted drugs and timely referral to a nephrologist is feasible and should be pursued within primary care.