TY - JOUR
T1 - Significance of eGFR and proteinuria for cardiovascular disease in individuals beyond 85 years of age
AU - Azegami, Tatsuhiko
AU - Kaneko, Hidehiro
AU - Okada, Akira
AU - Suzuki, Yuta
AU - Fujiu, Katsuhito
AU - Morita, Hiroyuki
AU - Takeda, Norifumi
AU - Takeda, Norihiko
AU - Fukui, Akira
AU - Yokoo, Takashi
AU - Node, Koichi
AU - Yasunaga, Hideo
AU - Nangaku, Masaomi
AU - Hayashi, Kaori
N1 - Publisher Copyright:
© 2024 The Author(s). Published by Oxford University Press on behalf of the ERA.
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Background: There are limited data on how advancing age influences prediction of cardiovascular disease (CVD) risk based on the estimated glomerular filtration rate (eGFR) and proteinuria, especially in older adults, including those aged ≥85 years old. This study aimed to clarify the association of eGFR and proteinuria with CVD outcomes and the impact of age on this association. Methods: The distribution of eGFR and urine protein in Japan was assessed retrospectively using real-world administrative claims and health checkup data collected between April 2014 and November 2022. We investigated the associations of these two parameters with the incidence of CVD, with an emphasis on the impact of aging. Results: We assessed 1 829 020 individuals for distribution of eGFR and proteinuria; after excluding those with known CVD, their association with CVD risk was examined in 1 040 101 individuals aged ≥40 years. The prevalence of impaired kidney function (eGFR <60 mL/min/1.73 m2) increased with age, being 0.7%, 9.2%, 21.9%, 40.2% and 60.2% at the ages of 18-39, 40-64, 65-74, 75-84 and ≥85 years, respectively (P for trend <.001); similarly, the proportion with positive proteinuria increased with age, being 2.7%, 4.3%, 5.6%, 9.2% and 15.8%, respectively (P for trend <.001). Both eGFR and urine protein were identified to be independent risk factors for CVD. Hazard ratios for CVD increased significantly when eGFR was <45 mL/min/1.73 m2 at the ages of 40-64, 65-74 and 75-84 years and <30 mL/min/1.73 m2 at ≥85 years, while proteinuria remained significantly associated with a high CVD risk regardless of age. These findings were consistent even when analyzed separately by sex. Conclusions: This study identified eGFR and urine dipstick proteinuria to be independent risk factors for CVD, even among individuals aged ≥85 years. However, the contribution of eGFR to the CVD risk was attenuated by aging, whereas proteinuria remained less affected by advancing age.
AB - Background: There are limited data on how advancing age influences prediction of cardiovascular disease (CVD) risk based on the estimated glomerular filtration rate (eGFR) and proteinuria, especially in older adults, including those aged ≥85 years old. This study aimed to clarify the association of eGFR and proteinuria with CVD outcomes and the impact of age on this association. Methods: The distribution of eGFR and urine protein in Japan was assessed retrospectively using real-world administrative claims and health checkup data collected between April 2014 and November 2022. We investigated the associations of these two parameters with the incidence of CVD, with an emphasis on the impact of aging. Results: We assessed 1 829 020 individuals for distribution of eGFR and proteinuria; after excluding those with known CVD, their association with CVD risk was examined in 1 040 101 individuals aged ≥40 years. The prevalence of impaired kidney function (eGFR <60 mL/min/1.73 m2) increased with age, being 0.7%, 9.2%, 21.9%, 40.2% and 60.2% at the ages of 18-39, 40-64, 65-74, 75-84 and ≥85 years, respectively (P for trend <.001); similarly, the proportion with positive proteinuria increased with age, being 2.7%, 4.3%, 5.6%, 9.2% and 15.8%, respectively (P for trend <.001). Both eGFR and urine protein were identified to be independent risk factors for CVD. Hazard ratios for CVD increased significantly when eGFR was <45 mL/min/1.73 m2 at the ages of 40-64, 65-74 and 75-84 years and <30 mL/min/1.73 m2 at ≥85 years, while proteinuria remained significantly associated with a high CVD risk regardless of age. These findings were consistent even when analyzed separately by sex. Conclusions: This study identified eGFR and urine dipstick proteinuria to be independent risk factors for CVD, even among individuals aged ≥85 years. However, the contribution of eGFR to the CVD risk was attenuated by aging, whereas proteinuria remained less affected by advancing age.
KW - cardiovascular disease
KW - estimated glomerular filtration rate
KW - older adults
KW - proteinuria
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UR - http://www.scopus.com/inward/citedby.url?scp=85213597256&partnerID=8YFLogxK
U2 - 10.1093/ndt/gfae124
DO - 10.1093/ndt/gfae124
M3 - Article
C2 - 38857890
AN - SCOPUS:85213597256
SN - 0931-0509
VL - 40
SP - 164
EP - 172
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 1
ER -
