Estimating glomerular filtration rate in older people.

Biomed Res Int. 2014;2014:916542. doi: 10.1155/2014/916542. Epub 2014 Mar 20. Estimating glomerular filtration rate in older people. Garasto S(1), Fusco S(2), Corica F(3), Rosignuolo M(1), Marino A(1), Montesanto A(4), De Rango F(4), Maggio M(5), Mari V(6), Corsonello A(1), Lattanzio F(7). Author information: (1)Unit of Geriatric Pharmacoepidemiology, Italian National Research Center on Aging (INRCA), C. da Muoio Piccolo, 87100 Cosenza, Italy. (2)Unit of Geriatric Pharmacoepidemiology, Italian National Research Center on Aging (INRCA), C. da Muoio Piccolo, 87100 Cosenza, Italy ; Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy. (3)Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy. (4)Department of Cell Biology, University of Calabria, 87036 Rende, Italy. (5)Department of Geriatric Rehabilitation, University-Hospital of Parma and Section of Geriatrics, Department of Clinical and Experimental Medicine, University of Parma, 43100 Parma, Italy. (6)Unit of Clinical Pathology, Italian National Research Center on Aging (INRCA), 87100 Cosenza, Italy. (7)Scientific Direction, Italian National Research Center on Aging (INRCA), 60127 Ancona, Italy. We aimed at reviewing age-related changes in kidney structure and function, methods for estimating kidney function, and impact of reduced kidney function on geriatric outcomes, as well as the reliability and applicability of equations for estimating glomerular filtration rate (eGFR) in older patients. CKD is associated with different comorbidities and adverse outcomes such as disability and premature death in older populations. Creatinine clearance and other methods for estimating kidney function are not easy to apply in older subjects. Thus, an accurate and reliable method for calculating eGFR would be highly desirable for early detection and management of CKD in this vulnerable population. Equations based on serum creatinine, age, race, and gender have been widely used. However, these equations have their own limitations, and no equation seems better than the other ones in older people. New equations specifically developed for use in older populations, especially those based on serum cystatin C, hold promises. However, further studies are needed to definitely accept them as the reference method to estimate kidney function in older patients in the clinical setting.