Natalie Ebert1, Olga Jakob2, Jens Gaedeke3, Markus van der Giet4, Martin K Kuhlmann5, Peter Martus6, Nina Mielke1, Mirjam Schuchardt4, Markus Tölle4, Volker Wenning7, Elke S Schaeffner1. 1. Institute of Public Health, Charité University Medicine, Campus Virchow, Berlin, Germany. 2. Institute for Biostatistics and Clinical Epidemiology, Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany. 3. Department of Nephrology, Charité University Medicine, Campus Mitte Berlin, Germany. 4. Department of Nephrology, Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany. 5. Department of Nephrology, Vivantes Klinikum im Friedrichshain, Berlin, Germany. 6. Institute of Clinical Epidemiology and Medical Biostatistics, Friedrich Karls-University, Tübingen, Germany. 7. AOK-Nordost - die Gesundheitskasse, Berlin, Germany.
Abstract
BACKGROUND: Although CKD is said to increase among older adults, epidemiologic data on kidney function in people ≥70 years of age are scarce. The Berlin Initiative Study (BIS) aims to fill this gap by evaluating the CKD burden in older adults. METHODS: The BIS is a prospective population-based cohort study whose participants are members of Germany's biggest insurance company. This cross-sectional analysis (i) gives a detailed baseline characterization of the participants, (ii) analyses the representativeness of the cohort's disease profile, (iii) assesses GFR and albuminuria levels across age categories, (iv) associates cardiovascular risk factors with GFR as well as albuminuria and (v) compares means of GFR values according to different estimating equations with measured GFR. RESULTS: A total of 2069 participants (52.6% female, mean age 80.4 years) were enrolled: 26.1% were diabetic, 78.8% were on antihypertensive medication, 8.7% had experienced a stroke, 14% a myocardial infarction, 22.6% had cancer, 17.8% were anaemic and 26.5% were obese. The distribution of comorbidities in the BIS cohort was very similar to that in the insurance 'source population'. Creatinine and cystatin C as well as the albumin:creatinine ratio (ACR) increased with increasing age. After multivariate adjustments, reduced GFR and elevated ACR were associated with most cardiovascular risk factors. The prevalence of a GFR <60 mL/min/1.73 m 2 ranged from 38 to 62% depending on the estimation equation used. CONCLUSIONS: The BIS is a very well-characterized, representative cohort of older adults. Participants with an ACR ≥30 had significantly higher odds for most cardiovascular risk factors compared with an ACR <30 mg/g. Kidney function declined and ACR rose with increasing age.
BACKGROUND: Although CKD is said to increase among older adults, epidemiologic data on kidney function in people ≥70 years of age are scarce. The Berlin Initiative Study (BIS) aims to fill this gap by evaluating the CKD burden in older adults. METHODS: The BIS is a prospective population-based cohort study whose participants are members of Germany's biggest insurance company. This cross-sectional analysis (i) gives a detailed baseline characterization of the participants, (ii) analyses the representativeness of the cohort's disease profile, (iii) assesses GFR and albuminuria levels across age categories, (iv) associates cardiovascular risk factors with GFR as well as albuminuria and (v) compares means of GFR values according to different estimating equations with measured GFR. RESULTS: A total of 2069 participants (52.6% female, mean age 80.4 years) were enrolled: 26.1% were diabetic, 78.8% were on antihypertensive medication, 8.7% had experienced a stroke, 14% a myocardial infarction, 22.6% had cancer, 17.8% were anaemic and 26.5% were obese. The distribution of comorbidities in the BIS cohort was very similar to that in the insurance 'source population'. Creatinine and cystatin C as well as the albumin:creatinine ratio (ACR) increased with increasing age. After multivariate adjustments, reduced GFR and elevated ACR were associated with most cardiovascular risk factors. The prevalence of a GFR <60 mL/min/1.73 m 2 ranged from 38 to 62% depending on the estimation equation used. CONCLUSIONS: The BIS is a very well-characterized, representative cohort of older adults. Participants with an ACR ≥30 had significantly higher odds for most cardiovascular risk factors compared with an ACR <30 mg/g. Kidney function declined and ACR rose with increasing age.
Authors: Bjørn O Eriksen; Runolfur Palsson; Natalie Ebert; Toralf Melsom; Markus van der Giet; Vilmundur Gudnason; Olafur S Indridason; Lesley A Inker; Trond G Jenssen; Andrew S Levey; Marit D Solbu; Hocine Tighiouart; Elke Schaeffner Journal: J Am Soc Nephrol Date: 2020-06-04 Impact factor: 10.121
Authors: Elke S Schaeffner; Natalie Ebert; Martin K Kuhlmann; Peter Martus; Nina Mielke; Alice Schneider; Markus van der Giet; Dörte Huscher Journal: Clin J Am Soc Nephrol Date: 2022-07-18 Impact factor: 10.614
Authors: Pierre Delanaye; Kitty J Jager; Arend Bökenkamp; Anders Christensson; Laurence Dubourg; Bjørn Odvar Eriksen; François Gaillard; Giovanni Gambaro; Markus van der Giet; Richard J Glassock; Olafur S Indridason; Marco van Londen; Christophe Mariat; Toralf Melsom; Olivier Moranne; Gunnar Nordin; Runolfur Palsson; Hans Pottel; Andrew D Rule; Elke Schaeffner; Maarten W Taal; Christine White; Anders Grubb; Jan A J G van den Brand Journal: J Am Soc Nephrol Date: 2019-09-10 Impact factor: 10.121