High Rates of Untreated Kidney Failure Seen in Elderly

TUESDAY, June 19 (HealthDay News) — Untreated kidney failure is
more prevalent among older adults than those who are younger, according to
Canadian researchers who say advanced kidney disease among the elderly may
be seriously underestimated.

In conducting the study, the researchers examined information on nearly
2 million adults in Alberta, Canada who had their flow rate of filtered
fluid through their kidney, called eGFR, measured between 2002 and 2008.
The patients’ eGFR had an initial, or “baseline,” reading that did not
require treatment (15 mL/min/1.73 m2 or higher).

At a follow-up after about four years, however, 5.4 percent of the
study participants had died, 0.18 percent had been treated for kidney
failure and 0.17 percent had untreated kidney failure, or had progressed
to an eGFR reading that was less than “baseline” without treatment,
according to the study published in the June 20 issue of the Journal of
the American Medical Association
.

The investigators found that adjusted rates of death increased as the
patients’ aged. They also found rates of treated kidney failure were
higher among the youngest age group.

For the patients with the lowest eGFR, adjusted rates of treated kidney
failure were more than 10 times higher among those between 18 and 44 years
of age than among the patients older than 85, the study authors noted in a
journal news release.

Meanwhile, the investigators found adjusted rates of untreated kidney
failure were more than five times higher among patients aged 85 years or
older than among those aged 18 to 44.

“These findings have important implications for clinical practice and
decision making; coupled with the finding that many older adults with
advanced chronic kidney disease are not adequately prepared for dialysis,
these results suggest a need to prioritize the assessment and recognition
of chronic kidney disease progression among older adults,” Dr. Brenda
Hemmelgarn, of the University of Calgary in Alberta, Canada, and her
colleagues said in the news release.

The researchers suggested that doctors should offer treatment for
kidney disease to older adults who could benefit from it. They also
concluded that there is a need for improvement in the identification of
older adults with chronic kidney disease and the development of
appropriate treatments.

In addition, more research is needed to better understand the factors
that influence older adults’ decisions to receive treatment for advanced
kidney disease, the study authors said.

More information

The U.S. National Library of Medicine has more about kidney failure.

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