Prevalence of Chronic Kidney Disease and its Risk Factors Among Elderly Family Practice Patients
Background and Objective. According to epidemiological data, every tenth person has chronic kidney disease. In the early stages, it is asymptomatic, and remains undiagnosed and untreated. Experts recommend examining the patients under risk. In Lithuania, there are insufficient data on the prevalence of chronic kidney disease in general population. Therefore, the aim of our study was to elucidate the prevalence of chronic kidney disease and its risk factors among elderly (> 65 years) family practice patients.
Methods. We reviewed 5880 ambulatory case records of all the patients older than 18 years in 2 primary care centers. We selected the patients with a high risk of chronic kidney disease (CKD) (with severe arterial hypertension, diabetes mellitus, primary kidney diseases, and complicated atherosclerosis). In the second part of the study, we performed the nephrological examination of the patients under risk.
Results. Overall, high risk factors of chronic kidney disease were established for 650 (11.05%) primary care patients. 434 patients (66.8%) having high risk factors of chronic kidney disease were older 65 years. Older patients had more frequent arterial hypertension (70.4% vs. 48.7%, P < 0.05) and cardiovascular disease (6.2% vs. 2.0%, P < 0.05), but fewer of them had primary kidney disease (29.8% vs. 43.1%, P < 0.05) compared with younger patients. Only 57.6% of elderly patients and 54.17% of nonelderly patients came for nephrological examination. Nephrological investigation revealed that elderly patients had more frequent eGFR < 60 mL/min/1.73 m² (45.8% vs. 22.3%, P < 0.001) and CKD (54.4% vs. 35.04%, P < 0.001) compared with younger. In the binary logistic regression analysis, the age over 65 years increased by 2.93 the odds ratio for kidney dysfunction. Elderly patients smoked less (14.5% vs. 27.4%, P = 0.003), had a lower body mass index (28.74 ± 4.49 vs. 30.68 ± 6.64, P = 0.001) and higher systolic blood pressure (155.73 ± 21.76 vs. 149.95 mmHg, P = 0.023)
Conclusion. Elderly population 2 times more often have risk factors, mainly multiple, and by 1.6 times more often were diagnosed with CKD.
Correspondence to A. Žilinskienė Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Eivenių str. 2, LT-50161, Kaunas, Lithuania E-mailing adress: alanta.zilinskiene@gmail.com