Decreased Kidney Function in the Elderly: Clinical and Preclinical, Neither Benign
Authors: Josef Coresh, Brad Astor
Journal: Annals of Internal Medicine (2006)

Editorials15 August 2006Decreased Kidney Function in the Elderly: Clinical and Preclinical, Neither BenignJosef Coresh, MD, PhD and Brad Astor, PhDJosef Coresh, MD, PhDFrom Johns Hopkins University, Baltimore, MD 21287.Search for more papers by this author and Brad Astor, PhDFrom Johns Hopkins University, Baltimore, MD 21287.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-145-4-200608150-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Decreased kidney function is extremely common in elderly persons and is also an important independent predictor of cardiovascular disease. An advance in detecting decreased kidney function and quantifying its prognostic and therapeutic implications is, therefore, important news for clinicians. In this issue, Shlipak and colleagues (1) advance our understanding of the broad consequences of mildly decreased kidney function in elderly persons. They also demonstrate that cystatin C has some advantages over serum creatinine as a marker of decreased glomerular filtration rate (GFR) in predicting future complications.Direct GFR measurements are expensive and inconvenient. Most large studies and most clinicians use ...References1. Shlipak MG, Katz R, Sarnak MJ, Fried LF, Newman AB, Stehman-Breen C, et al. Cystatin C and prognosis for cardiovascular and kidney outcomes in elderly persons without chronic kidney disease. Ann Intern Med. 2006;145:237-46. LinkGoogle Scholar2. Levey AS, Coresh J, Greene T, Stevens LA, Zhang Y, Hendriksen S, et al. Using standardized serum creatinine values in the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145:247-54. LinkGoogle Scholar3. Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function—measured and estimated glomerular filtration rate. N Engl J Med. 2006;354:2473-83. [PMID: 16760447] CrossrefMedlineGoogle Scholar4. Dharnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis. 2002;40:221-6. [PMID: 12148093] CrossrefMedlineGoogle Scholar5. Laterza OF, Price CP, Scott MG. Cystatin C: an improved estimator of glomerular filtration rate? Clin Chem. 2002;48:699-707. [PMID: 11978596] CrossrefMedlineGoogle Scholar6. Rule AD, Bergstralh EJ, Slezak JM, Bergert J, Larson TS. Glomerular filtration rate estimated by cystatin C among different clinical presentations. Kidney Int. 2006;69:399-405. [PMID: 16408133] CrossrefMedlineGoogle Scholar7. Grubb A, Nyman U, Björk J, Lindström V, Rippe B, Sterner G, et al. Simple cystatin C-based prediction equations for glomerular filtration rate compared with the Modification of Diet in Renal Disease prediction equation for adults and the Schwartz and the Counahan-Barratt prediction equations for children. Clin Chem. 2005;51:1420-31. [PMID: 15961546] CrossrefMedlineGoogle Scholar8. Coresh J, Stevens LA, Greene T, Eggers O, Kusek J, Van Lente F, et al. Comparison of GFR estimating equations using serum cystatin and creatinine: a pooled analysis of 1706 individuals [Abstract]. J Am Soc Nephrol. 2005;16:69A. Google Scholar9. Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005;67:2089-100. [PMID: 15882252] CrossrefMedlineGoogle Scholar10. Coresh J, Byrd-Holt D, Astor BC, Briggs JP, Eggers PW, Lacher DA, et al. Chronic kidney disease awareness, prevalence, and trends among U.S. adults, 1999 to 2000. J Am Soc Nephrol. 2005;16:180-8. [PMID: 15563563] CrossrefMedlineGoogle Scholar11. Newman DJ. Cystatin C. Ann Clin Biochem. 2002;39:89-104. [PMID: 11928770] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Josef Coresh, MD, PhD; Brad Astor, PhDAffiliations: From Johns Hopkins University, Baltimore, MD 21287.Disclosures: None disclosed.Grant Support: Drs. Coresh and Astor are partly supported by 5U01DK067651.Corresponding Author: Josef Coresh, MD, PhD, Johns Hopkins University, 2024 East Monument Street, Suite 2-600, Baltimore, MD 21287; e-mail, [email protected]edu.Current Author Addresses: Drs. Coresh and Astor: Johns Hopkins University, 2024 East Monument Street, Suite 2-600, Baltimore, MD 21287. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCystatin C and Prognosis for Cardiovascular and Kidney Outcomes in Elderly Persons without Chronic Kidney Disease Michael G. Shlipak , Ronit Katz , Mark J. Sarnak , Linda F. Fried , Anne B. Newman , Catherine Stehman-Breen , Stephen L. Seliger , Brian Kestenbaum , Bruce Psaty , Russell P. Tracy , and David S. Siscovick Using Standardized Serum Creatinine Values in the Modification of Diet in Renal Disease Study Equation for Estimating Glomerular Filtration Rate Andrew S. Levey , Josef Coresh , Tom Greene , Lesley A. Stevens , Yaping (Lucy) Zhang , Stephen Hendriksen , John W. Kusek , Frederick Van Lente , and Metrics Cited byEstimation of Glomerular Filtration Rate in Elderly Chronic Kidney Disease Patients: Comparison of Three Novel Sophisticated Equations and Simple Cystatin C EquationDiferencias entre filtrado glomerular disminuido e insuficiencia renal: riesgos de asociar estos 2 conceptos en el anciano sanoIndividualization of drug therapy in older peopleRelationship Between Body Mass Index and High Cystatin Levels Among US AdultsSimple Cystatin C Formula Compared to Sophisticated CKD-EPI Formulas for Estimation of Glomerular Filtration Rate in the ElderlyReview on Pharmacokinetics and Pharmacodynamics and the Aging KidneyAssociation between markers of renal function and C‐reactive protein level in the elderly: Confounding by functional statusCystatin C: current position and future prospectsCoronary heart disease and cardiovascular autonomic neuropathy in the elderly diabeticBias and precision of estimated glomerular filtration rate in childrenChronic kidney disease (CKD) in the elderly – a geriatrician's perspective 15 August 2006Volume 145, Issue 4Page: 299-301KeywordsAttentionCardiovascular disease riskCardiovascular diseasesChronic kidney diseaseCreatinineElderlyKidneysMedical risk factorsRenal diseasesStatistical methods ePublished: 15 August 2006 Issue Published: 15 August 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. 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