1. Nephrosclerosis impacts time trajectory of renal function and outcomes in elderly individuals with chronic kidney disease
- Author
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Giorgio Fuiano, Giovanni Ruotolo, Michele Andreucci, Alessandro Comi, Davide Bolignano, Paola Cianfrone, Maria Teresa Zicarelli, Giuseppe Coppolino, Alberto Castagna, Pierangela Presta, Nicolino Comi, and Gemma Patella
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,030232 urology & nephrology ,Renal function ,030204 cardiovascular system & hematology ,Kidney ,urologic and male genital diseases ,Left ventricular hypertrophy ,Essential hypertension ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Hypertensive Nephropathy ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Renal replacement therapy ,Renal Insufficiency, Chronic ,Aged ,Creatinine ,Nephrosclerosis ,business.industry ,General Medicine ,medicine.disease ,female genital diseases and pregnancy complications ,ErbB Receptors ,chemistry ,Disease Progression ,Cardiology ,Kidney Failure, Chronic ,business ,Kidney disease - Abstract
Despite hypertension ranks among the leading causes of chronic kidney disease (CKD), the impact of chronic hypertensive nephropathy, the so-called ‘nephrosclerosis’ (NS), on CKD progression is often unpredictable, particularly in elderly population. We have conducted a prospective, observational study to define renal function patterns and outcomes in elderly CKD individuals with or without NS. Three hundred four individuals with an already established CKD were categorized according to the etiology of CKD. NS was defined as the presence of CKD associated with long-term essential hypertension, hypertensive retinopathy, left ventricular hypertrophy and minimal proteinuria. Time trajectories in estimated glomerular filtration rate (eGFR) (CKD-Epi) were computed over a 4-year follow-up. In addition, we analyzed the occurrence of a composite outcome of doubling of serum creatinine levels, eGFR reduction ≥25% and/or the need of chronic renal replacement therapy. CKD was secondary to nephrosclerosis (CKD-NS) in 220 (72.3%). In the whole cohort, the average estimated annual GFR slope was 1.8 mL/min/1.73 m2. eGFR decline was slower in CKD-NS as compared with others (1.4 vs 3.4 mL/min/1.73 m2; p
- Published
- 2021