Estimated glomerular filtration rate and functional status among older people: A systematic review

• Published in: European journal of internal medicine Vol. 56; no. SI; pp. 39 - 48
• Main Authors: Corsonello, Andrea, Roller-Wirnsberger, Regina, Di Rosa, Mirko, Fabbietti, Paolo, Wirnsberger, Gerhard, Kostka, Tomasz, Guligowska, Agnieszka, Tap, Lisanne, Mattace-Raso, Francesco, Gil, Pedro, Guardado-Fuentes, Lara, Meltzer, Itshak, Yehoshua, Ilan, Artzi-Medevdik, Rada, Formiga, Francesc, Moreno-González, Rafael, Weingart, Christian, Freiberger, Ellen, Ärnlöv, Johan, Carlsson, Axel C., Lattanzio, Fabrizia
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2018
• Subjects: Aged; Creatinine; Creatinine - blood; Cystatin C; Cystatin C - blood; Disability; Disability Evaluation; Estimated glomerular filtration rate (eGFR); Frail Elderly; Frailty; Frailty - physiopathology; Glomerular Filtration Rate; Hand Strength - physiology; Health and Welfare; Humans; Hälsa och välfärd; Medicin och hälsovetenskap; Predictive Value of Tests; Creatinine; Disability; Estimated glomerular filtration rate (eGFR); Frailty; Cystatin C
• DOI: 10.1016/j.ejim.2018.05.030
• ISSN: 0953-6205; 1879-0828

The association between chronic kidney disease (CKD) and functional status may change as a function of the equation used to estimate glomerular filtration rate (eGFR). We reviewed the predictive value of different eGFR equations in regard to frailty and disability outcomes. We searched Pubmed from inception to March 2018 for studies investigating the association between eGFR and self-reported and/or objective measures of frailty or disability. Cross-sectional and longitudinal studies were separately analysed. We included 16 studies, one of which reporting both cross-sectional and longitudinal data. Three out of 7 cross-sectional studies compared different eGFR equations in regard to their association with functional status: two studies showed that cystatin C-based, but not creatinine-based eGFR may be associated with hand-grip strength or frailty; another study showed that two different creatinine-based eGFR equations may be similarly associated with disability. Four out of 10 longitudinal studies provided comparative data: two studies reported similar association with disability for different creatinine-based eGFR equations; one study showed that creatinine-based eGFR was not associated with frailty, but a not significant trend for association was observed with cystatin C-based eGFR; one study showed that cystatin C-based but not creatinine-based eGFR may predict incident mobility disability, while both methods may predict gait speed decline. High heterogeneity was observed in regard to confounders included in reviewed studies. None of them included the most recently published equations. Available data do not support the superiority of one of the eGFR equations in terms of measuring or predicting functional decline. •The association CKD-frailty/disability may be affected by the eGFR equation used.•Only few cross-sectional and longitudinal studies compared different equations.•Cystatin C- but not creatinine-eGFR may be associated with functional status.•Studies including recent eGFR equations developed for older people are lacking.•Evidence does not allow to prove which eGFR equation may better predict function.