Chronic kidney disease in Polish elderly population aged 75+: results of the WOBASZ Senior Survey

Abstract

PurposeKidney filtration decreases with age, which results in an increased frequency of chronic kidney disease (CKD) in the elderly population. The purpose of the study was to assess the prevalence and epidemiology of CKD in the Polish elderly population.MethodsA representative sample of the Polish elderly population, composed of 918 people (F 452, M 466) in the age of ≥75 years, was chosen. All participants had their history, anthropometric measures and biochemical parameters (creatinine, fasting glucose, complete cholesterol) evaluated. CKD was diagnosed when eGFR was <60 ml/min/1.73 m2. The comorbidities, anthropometric and social factors connected with the onset of CKD were also analyzed.ResultsThe prevalence of CKD in the analyzed population was 26.9% (F 32.0%, M 15.8%), which gives an estimated number of 495,590 (95% CI 396,363–594,817) patients in the study subpopulation. The majority of these people were in the G3A category—70.1%, while the remaining fell under the G3B—25.7%, G4—3.1% and G5—1.1% categories. Disease awareness among the participants was found to be at 17%. Arterial hypertension (AH) was more frequent in people with CKD (91.0 vs. 80.3%, P < 0.001), whereas diabetes mellitus (DM) prevalence was comparable in both CKD and non-CKD groups (11.7 vs. 11.4%, ns). In the examined group, DM had no influence on the frequency of CKD. In contrast, the presence of cardiovascular diseases substantially increased the chances of developing CKD (OR 1.87, P < 0.05).Conclusion1. The prevalence of CKD in the Polish elderly population was 26.9%. 2. Awareness of CKD is low. 3. DM, increasing age and AH did not increase the risk of CKD. 4. Coexistence of cardiovascular diseases increased the risk of having CKD.

CKD: A Call for an Age-Adapted Definition

“…1 CKD categories 3 or 3a are unequivocally the largest or second largest group in terms of CKD prevalence in other studies as well. 47,48,55,56,97,123,[130][131][132][133][134][135][136][137][138][139] The epidemiologic literature clearly shows that CKD prevalence increases with age when using the fixed-threshold CKD definition of 60 ml/min per 1.73 m 2 . 1, 48,56,97,101,123,[130][131][132][133][134][138][139][140][141][142][143] Most older subjects defined as having CKD have a GFR of 45-59 ml/min per 1.73 m 2 and normal urine ACR, whereas the younger individuals more frequently have elevated urine ACR and GFR .60 ml/min per 1.73 m 2 .…”

International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Eastern and Central Europe

“…According to the WOBASZ Senior Survey, the prevalence of CKD among people in Poland aged 75 years and older is 26.9%; the frequency of CKD increases with age, from 24.2% (75-79 years) to 37.2% (90þ years). 27 The majority (70.1%) of people with CKD are in stage G3A. 27 In 2018, patients over the age of 65 comprised more than 60% of incident HD patients, and patients over the age of 75 accounted for over 30% of long-term dialysis (PD and HD).…”

“…27 The majority (70.1%) of people with CKD are in stage G3A. 27 In 2018, patients over the age of 65 comprised more than 60% of incident HD patients, and patients over the age of 75 accounted for over 30% of long-term dialysis (PD and HD). 5 Given these trends, the life quality of elderly patients, particularly those requiring frequent KRT treatments, has become a central focus.…”

Conservative Management in End-Stage Kidney Disease between the Dialysis Myth and Neglected Evidence-Based Medicine

“…In the CKD population, the traditional risk factors, such as diabetes mellitus, hypertension, congestive heart failure, clinical depression, history of ischemic heart disease, cerebrovascular disease, the presence of cancer, and physical and nutritional impairment, also contribute to increasing the CV mortality risk [ 5 , 6 ]. Thus, elderly patients with ESKD and high comorbidity have an even higher mortality risk [ 7 , 8 , 9 ]. Finally, some non-traditional risk factors for CV events related to ESKD, such as anemia, phosphate increase [ 10 ], and potassium imbalance [ 11 ], further aggravate the mortality risk in CKD patients.…”