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Revista Clínica de Medicina de Familia
versão On-line ISSN 2386-8201versão impressa ISSN 1699-695X
Resumo
BLAZQUEZ ALCAZAR, José David et al. Renal function monitoring and factors influencing its evolution in a cohort of persons aged 65-74. Rev Clin Med Fam [online]. 2020, vol.13, n.2, pp.116-122. Epub 21-Set-2020. ISSN 2386-8201.
Objectives:
To study the evolution of renal function in younger elderly persons over a period of four years.
Design:
Observational, descriptive, longitudinal study.
Setting:
Urban health centre
Participants:
Population between 65 and 74 years of age assigned to a health centre
Main measures:
Creatinine and glomerular filtration rate according to CKD-EPI. Also sociodemographic variables, cardiovascular risk factors, and number of chronic diseases and drugs
Results:
The initial sample included 557 patients, with 12.9 % loss at the end of the study. At the start, the average age was 68.9 years, with 55.1 % women. The mean creatinine evolved from 0.87 mg/dl (95% CI 0.83-0.91) to 0.94 (95%CI 0.87-0.99) (p<0.05). The mean glomerular filtration rate evolved from 79.1 ml/min (95% CI 77.9-80.4) to 74.65 (95% CI 73.3-76.0) (p<0.001), with an average decrease of 4.3 ml/min (95% CI 3.4-5.2). Initially, 10.2% of patients (95% CI 7.7-12.7) presented chronic kidney failure, which increased to 15.3 % (95% CI 12.1-18.5) at the end, being all the increase within stage 3. The bivariate analysis showed association between greater decline of filtration rate and presence of high blood pressure (p<0.05), number of diseases (p<0.01) and female sex (p<0.05). However, in the multivariate analysis only female sex kept a significant association (p<0.05), and high blood pressure had a nearly significant association (p<0.1), but with clinically irrelevant differences.
Conclusions:
Among younger elderly patients, the renal function seems to present a very slow decline over time, which is slightly greater in women. Spacing of renal function determinations could be considered in general population of this age group .
Palavras-chave : Aged; Renal Insufficiency Chronic; Prevalence; Primary care.