Distribution of estimated glomerular filtration rate and determinants of its age dependent loss in a German population-based study

• Published in: Scientific reports Vol. 11; no. 1; pp. 10165 - 13
• Main Authors: Waas, Thomas, Schulz, Andreas, Lotz, Johannes, Rossmann, Heidi, Pfeiffer, Norbert, Beutel, Manfred E., Schmidtmann, Irene, Münzel, Thomas, Wild, Philipp S., Lackner, Karl J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 13.05.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4022; 692/499; Adult; Age; Age Factors; Aged; Albuminuria - physiopathology; Antidiabetics; Antihypertensives; Blood Pressure; Cohort Studies; Cross-Sectional Studies; Diabetes mellitus; Diuretics; Epidermal growth factor receptors; Female; Germany; Glomerular Filtration Rate; Heart; Humanities and Social Sciences; Humans; Kidney - physiology; Kidney diseases; Male; Middle Aged; multidisciplinary; Population studies; Population-based studies; Public health; Regression analysis; Risk Factors; Science; Science (multidisciplinary); Sensitivity analysis; Serum Albumin - metabolism; Uric acid; Uric Acid - blood; Ventricle; Ventricular Function, Left; Germany
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-89442-7

Glomerular filtration rate (GFR) declines with age by approx. 1 ml/min/m 2 per year beginning in the third decade of life. At 70 years of age > 40 ml/min/m 2 of GFR will be lost. Thus, factors affecting loss of GFR have significant public health implications. Furthermore, the definition of chronic kidney disease based on GFR may not be appropriate for the elderly. We analyzed factors affecting absolute and relative change of eGFR over a 5 year period in 12,381 participants of the Gutenberg Health Study. We estimated GFR at baseline and after 5 years of follow-up by two different equations. Association with the decline of estimated GFR (eGFR) was assessed by multivariable regression analysis. We confirmed a median loss of eGFR per year of approx. 1 ml/min/m 2 . Aside from albuminuria systolic blood pressure was most strongly associated with faster decline of eGFR followed by echocardiographic evidence of left ventricular diastolic dysfunction and reduced ejection fraction. White blood cell count showed a moderate association with eGFR loss. Diastolic blood pressure, serum uric acid and serum albumin were associated with slower GFR decline in multivariable analysis. Sensitivity analysis with exclusion of individuals taking diuretics, antihypertensive, antidiabetic, or lipid lowering drugs confirmed these associations.