Bjørn O Eriksen1,2, Runolfur Palsson3,4, Natalie Ebert5, Toralf Melsom6,2, Markus van der Giet7, Vilmundur Gudnason4,8, Olafur S Indridason3, Lesley A Inker9, Trond G Jenssen6,10, Andrew S Levey9, Marit D Solbu6,2, Hocine Tighiouart11,12, Elke Schaeffner5. 1. Metabolic and Renal Research Group, University of Tromsø - The Arctic University of Norway, Tromsø, Norway bjorn.odvar.eriksen@unn.no. 2. Section of Nephrology, Clinic of Internal Medicine, University Hospital of North Norway, Tromsø, Norway. 3. Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 4. University of Iceland, Reykjavik, Iceland. 5. Institute of Public Health, Charité - Berlin University of Medicine, Berlin, Germany. 6. Metabolic and Renal Research Group, University of Tromsø - The Arctic University of Norway, Tromsø, Norway. 7. Department of Nephrology, Charité - Berlin University of Medicine, Berlin, Germany. 8. Icelandic Heart Association, Kopavogur, Iceland. 9. Division of Nephrology, Tufts Medical Center, Boston, Massachusetts. 10. Department of Organ Transplantation, Oslo University Hospital and University of Oslo, Oslo, Norway. 11. Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts. 12. Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts.
Abstract
BACKGROUND: Population mean GFR is lower in older age, but it is unknown whether healthy aging is associated with preserved rather than lower GFR in some individuals. METHODS: We investigated the cross-sectional association between measured GFR, age, and health in persons aged 50-97 years in the general population through a meta-analysis of iohexol clearance measurements in three large European population-based cohorts. We defined a healthy person as having no major chronic disease or risk factors for CKD and all others as unhealthy. We used a generalized additive model to study GFR distribution by age according to health status. RESULTS: There were 935 (22%) GFR measurements in persons who were healthy and 3274 (78%) in persons who were unhealthy. The mean GFR was lower in older age by -0.72 ml/min per 1.73 m2 per year (95% confidence interval [95% CI], -0.96 to -0.48) for men who were healthy versus -1.03 ml/min per 1.73 m2 per year (95% CI, -1.25 to -0.80) for men who were unhealthy, and by -0.92 ml/min per 1.73 m2 per year (95% CI, -1.14 to -0.70) for women who were healthy versus -1.22 ml/min per 1.73 m2 per year (95% CI, -1.43 to -1.02) for women who were unhealthy. For healthy and unhealthy people of both sexes, both the 97.5th and 2.5th GFR percentiles exhibited a negative linear association with age. CONCLUSIONS: Healthy aging is associated with a higher mean GFR compared with unhealthy aging. However, both the mean and 97.5 percentiles of the GFR distribution are lower in older persons who are healthy than in middle-aged persons who are healthy. This suggests that healthy aging is not associated with preserved GFR in old age.
BACKGROUND: Population mean GFR is lower in older age, but it is unknown whether healthy aging is associated with preserved rather than lower GFR in some individuals. METHODS: We investigated the cross-sectional association between measured GFR, age, and health in persons aged 50-97 years in the general population through a meta-analysis of iohexol clearance measurements in three large European population-based cohorts. We defined a healthy person as having no major chronic disease or risk factors for CKD and all others as unhealthy. We used a generalized additive model to study GFR distribution by age according to health status. RESULTS: There were 935 (22%) GFR measurements in persons who were healthy and 3274 (78%) in persons who were unhealthy. The mean GFR was lower in older age by -0.72 ml/min per 1.73 m2 per year (95% confidence interval [95% CI], -0.96 to -0.48) for men who were healthy versus -1.03 ml/min per 1.73 m2 per year (95% CI, -1.25 to -0.80) for men who were unhealthy, and by -0.92 ml/min per 1.73 m2 per year (95% CI, -1.14 to -0.70) for women who were healthy versus -1.22 ml/min per 1.73 m2 per year (95% CI, -1.43 to -1.02) for women who were unhealthy. For healthy and unhealthy people of both sexes, both the 97.5th and 2.5th GFR percentiles exhibited a negative linear association with age. CONCLUSIONS: Healthy aging is associated with a higher mean GFR compared with unhealthy aging. However, both the mean and 97.5 percentiles of the GFR distribution are lower in older persons who are healthy than in middle-aged persons who are healthy. This suggests that healthy aging is not associated with preserved GFR in old age.
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