Prevalence, trends and functional impairment associated with reduced estimated glomerular filtration rate and albuminuria among the oldest-old U.S. adults

摘要

Background: The prevalence of reduced estimated glomerular filtration rate (eGFR) among U.S. adults aged 80 years and older increased between 1988 to 1994 and 2005 to 2010. Trends in the prevalence of albuminuria over this time period have not been reported in this population. Methods: We conducted a cross-sectional analysis of U.S. adults aged 80 years and older in the National Health and Nutrition Examination Survey 1988 to 1994 (n = 1020), 1999 to 2004 (n = 995) and 2005 to 2010 (n = 971) to calculate the prevalence of albuminuria (albumin-to-creatinine ratio [ACR] ≥30 mg/g) by calendar period. The number of U.S. adults aged 80 years and older with elevated ACR and separately reduced eGFR was calculated by calendar period. Results: Among participants aged 80 years and older, the prevalence of albuminuria was 30.9%, 33.0% and 30.6% in 1988 to 1994, 1999 to 2004 and 2005 to 2010 (P = 0.9). The proportion of U.S. adults aged 80 years and older with both eGFR <45 ml/min/1.73 m and ACR ≥30 mg/g increased from 6.8% in 1988 to 1994 to 8.4% and 9.5% in 1999 to 2004 and 2005 to 2010, respectively (P = 0.008). In 1988 to 1994, 1999 to 2004 and 2005 to 2010, there were 1.78 (95% confidence interval [CI], 1.29-2.27), 2.35 (95% CI, 1.93-2.78) and 2.74 (95% CI, 2.32-3.16) million U.S. adults aged 80 years older with albuminuria and 2.34 (95% CI, 1.79-2.89), 3.55 (95% CI, 2.96-4.14) and 4.58 (95% CI, 3.87-5.28) million, respectively, with eGFR <60 ml/min/1.73 m. Conclusions: The proportion of U.S. adults aged 80 years and older with an elevated ACR remained relatively stable between 1988 to 1994 and 2005 to 2010. However, due to the growth of the oldest-old, the absolute number with albuminuria increased substantially over the past 2 decades.