Etiology, Diagnosis, and Management of Chronic Renal Insufficiency in the Aged

  • Jordan L. Rosenstock
  • Michael F. Michelis


Chronic Kidney Disease Renal Biopsy Uric Acid Level Chronic Renal Insufficiency Glomerular Disease 


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  1. 1.
    U.S. Renal Data System, USRDS 2005 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2004.Google Scholar
  2. 2.
    Coresh, J., Byrd-Holt, D., Astor, B.C., et al. Chronic kidney disease awareness, prevalence, and trends among U.S. adults, 1999 to 2000. J. Am. Soc. Nephrol. 2005; 16:180–188.PubMedCrossRefGoogle Scholar
  3. 3.
    Harris, M.I., Flegal, K.M., Cowie, C.C., et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. Diabetes Care 1998; 21:518–524.PubMedCrossRefGoogle Scholar
  4. 4.
    Wilson, P.W.F., Anderson, K.M., Kanel, W.B. Epidemiology of diabetes mellitus in the elderly: The Framingham Study. Am. J. Med. 1986; 80:S5A, 3–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Fields, L.E., Burt, V.L., Cutler, J.A., et al. The burden of adult hypertension in the United States 1999 to 2000: A rising tide. Hypertension 2004; 44:398–404.PubMedCrossRefGoogle Scholar
  6. 6.
    Schmeider, R.E., Frohlich, E.D., Messerli, F.H. Pathophysiology of hypertension in the elderly. Cardiol. Clin. 1986; 4:235–243.Google Scholar
  7. 7.
    Davison, A., Johnston, P.A. Idiopathic glomerulonephritis in the elderly. In Contributions in Nephrology. Basel: Karger. 1993; pp. 38–48.Google Scholar
  8. 8.
    Nair, R., Bell, J.M., Walker, P.D. Renal biopsy in patients aged 80 years and older. Am. J. Kidney Dis. 2004; 44:618–626.PubMedCrossRefGoogle Scholar
  9. 9.
    Modesto-Segonds, A., Ah-Soune, M.F., Durand, D., et al. Renal biopsy in the elderly. Am. J. Nephrol. 1993; 13:27–34.PubMedGoogle Scholar
  10. 10.
    Moorthy, A.V., Zimmerman, S.W. Renal disease in the elderly: Clinopathologic analysis of renal disease in 115 elderly patients. Clin. Nephrol. 1980; 14:223–229.PubMedGoogle Scholar
  11. 11.
    Colombo, V., Confalonieri, R., Minola, E., et al. Renal biopsies in the elderly. In Contributions in Nephrology. Basel: Karger. 1993; pp. 102–105.Google Scholar
  12. 12.
    Preston, R.A., Stemmer, C.L., Materson, B.J., et al. Renal biopsy in patients 65 years of age or older: An analysis of the results of 334 biopsies. J. Am. Geriatr. Soc. 1990; 38:669–674.PubMedGoogle Scholar
  13. 13.
    Coen, G., Manni, M., Giannoni, M.F., et al. Ischemic nephropathy in an elderly nephrologic and hypertensive population. Am. J. Nephrol. 1998; 18:221–227.PubMedCrossRefGoogle Scholar
  14. 14.
    Textor, S.T. Ischemic nephropathy: Where are we now? J. Am. Soc. Nephrol. 2004; 15:1974–1982.PubMedCrossRefGoogle Scholar
  15. 15.
    Safian, R., Textor, S.C. Renal-artery stenosis. N. Engl. J. Med. 2001; 344:431–442.PubMedCrossRefGoogle Scholar
  16. 16.
    Perneger, T.V., Whelton, P.K., Klag, M.J. Risk of kidney failure associated with the use of acetaminophen, aspirin and nonsteroidal anti-inflammatory drugs. N. Engl. J. Med. 1994; 331:1675–1679.PubMedCrossRefGoogle Scholar
  17. 17.
    Fored, C.M., Ejerblad, E., Lindblad, P., et al. Acetaminophen, aspirin, and chronic renal failure. N. Engl. J. Med. 2001; 345:1801–1808.PubMedCrossRefGoogle Scholar
  18. 18.
    McLaughlin, J.K., Lipworth, L., Chow, W.H., et al. Analgesic use and chronic renal failure: A critical review of the epidemiological literature. Kidney Int. 1998; 54:679–686.PubMedCrossRefGoogle Scholar
  19. 19.
    Ibanez, L., Morlans, M., Vidal, X., et al. Case-control study of regular analgesic and nonsteroidal anti-inflammatory use and end stage renal disease. Kidney Int. 2005; 67:2393–2398.PubMedCrossRefGoogle Scholar
  20. 20.
    De Broe, M.E., Elseviers, M.M. Analgesic nephropathy. N. Engl. J. Med. 1998; 338:446–452.PubMedCrossRefGoogle Scholar
  21. 21.
    Markowitz, G.S., Stokes, M.B., Radhakrishnan, J., et al. Acute phosphate nephropathy following an oral sodium phosphate bowel purgative: An underrecognized cause of chronic renal failure. J. Am. Soc. Nephrol. 2005; 16: 3389–3396.PubMedCrossRefGoogle Scholar
  22. 22.
    Kyle, R.A., Therneau, T.M., Rajkumar, S.V., et al. Prevalence of monoclonal gammopathy of undetermined significance. N. Engl. J. Med. 2006; 354: 1362–1369.PubMedCrossRefGoogle Scholar
  23. 23.
    Kyle, R.A., Therneau, T.M., Rajkumar, S.V., et al. A long term study of prognosis in monoclonal gammopathy of undetermined significance. N. Engl. J. Med. 2002; 346:564–569.PubMedCrossRefGoogle Scholar
  24. 24.
    Trevisan, R., Vedovato, Mazzon, C., et al. Concomitance of diabetic retinopathy and proteinuria accelerates the rate of decline of kidney function in type 2 diabetic patients. Diabetes Care 2002; 25:2026–2031.Google Scholar
  25. 25.
    Levey, A.S., Bosch, J.P., Lewis, J.B., et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Ann. Intern. Med. 1999; 130:461–470.PubMedGoogle Scholar
  26. 26.
    Levey, A.S., Coresh, J., Balk, E., et al. National Kidney Foundation practice guidelines for chronic kidney disease: Evaluation, classification and stratification. Ann. Intern. Med. 2003; 139:137–147.PubMedGoogle Scholar
  27. 27.
    Lamb, E.J., Webb, M.C., Simpson, D.E., et al. Estimation of glomerular filtration rate in older patients with chronic renal insufficiency: Is the modification of diet in renal disease formula an improvement? J. Am. Geriatr. Soc. 2003; 51:1012–1017.PubMedCrossRefGoogle Scholar
  28. 28.
    Dharnidharka, V.R., Kwon, C., Stevens, G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: A meta-analysis. Am. J. Kidney Dis. 2004; 43:861–867.CrossRefGoogle Scholar
  29. 29.
    Shlipak, M.G., Sarnak, M.J., Katz, R., et al. Cystatin C and the risk of death and cardiovascular events among elderly persons. N. Engl. J. Med. 2005; 352: 2049–2060.PubMedCrossRefGoogle Scholar
  30. 30.
    Sarnak, M.J., Katz, R., Stehman-Breen, C., et al. Cystatin C concentration as a risk factor for heart failure in older adults. Ann. Intern. Med. 2005; 142:497–505.PubMedGoogle Scholar
  31. 31.
    Shlipak, M.G., Katz, R., Sarnak, M.J., et al. Cystatin C and prognosis for cardiovascular and kidney outcomes in elderly persons without chronic kidney disease. Ann. Intern. Med. 2006; 145:237–246.PubMedGoogle Scholar
  32. 32.
    Fliser, D., Ritz, E. Serum cystatin C concentration as a marker of renal dysfunction in the elderly. Am. J. Kidney Dis. 2001; 37:79–83.PubMedGoogle Scholar
  33. 33.
    Jafar, T.H., Stark, P.C., Schmid, C.H., et al. Progression of chronic kidney disease: The role of blood pressure control, proteinuria, and angiotensin-converting enzyme inhibition: A patient level meta-analysis. Ann. Intern. Med. 2003; 19:244–252.Google Scholar
  34. 34.
    Pohl, M.A., Blumenthal, S., Cordonnier, D.J., et al. Independent and additive impact of blood pressure control and angiotensin II receptor blockade on renal outcomes in the irbesartan diabetic nephropathy trial: Clinical implications and limitations. J. Am. Soc. Nephrol. 2005; 16:3027–3037.PubMedCrossRefGoogle Scholar
  35. 35.
    Sarnak, M.J., Greene, T., Wang, X., et al. The effect of lower target blood pressure on the progression of kidney disease: Long term follow-up of the Modification of Diet in Renal Disease Study. Ann. Intern. Med. 2005; 142:342–351.PubMedGoogle Scholar
  36. 36.
    Wright, J.T., Bakris, G., Greene, T., et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: Results from the AASK trial. JAMA 2002; 20:2421–2431.CrossRefGoogle Scholar
  37. 37.
    Messerli, F.H., Mancia, G., Conti, R., et al. Dogma disputed: Can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous? Ann. Intern. Med. 2006; 144:884–893.PubMedGoogle Scholar
  38. 38.
    van Bemmel, T., Woittiez, K., Blauw, G.J., et al. Prospective study of the effect of blood pressure on renal function in old age: The Leiden 85-Plus Study. J. Am. Soc. Nephrol. 2006; 17:2561–2566.PubMedCrossRefGoogle Scholar
  39. 39.
    Chobanian, A., Bakris, G.L., Black, H., et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA 2003; 289:2560–2571.PubMedCrossRefGoogle Scholar
  40. 40.
    Casas, J.P., Chua, W., Loukogeorgakis, S., et al. Effect of inhibitors of the renin-angiotensin system and other antihypertensive drugs on renal outcomes: Systematic review and meta-analysis. Lancet 2005; 366:2026–2033.PubMedCrossRefGoogle Scholar
  41. 41.
    ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. diuretic. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288:2981–2997.Google Scholar
  42. 42.
    Hou, F.F., Zhang, X., Zhang, G.H., et al. Efficacy and safety of benazepril for advanced chronic renal insufficiency. N. Engl. J. Med. 2006; 354:131–140.PubMedCrossRefGoogle Scholar
  43. 43.
    Douglas, K., O’Malley, P.G., Jackson, J.L. Meta-analysis: The effect of statins on albuminuria. Ann. Intern. Med. 2006; 145:117–124.PubMedGoogle Scholar
  44. 44.
    Sandhu, S., Wiebe, N., Fried, L.F. Statins for improving renal outcomes: A meta-analysis. J. Am. Soc. Nephrol. 2006; 17:2006–2016.PubMedCrossRefGoogle Scholar
  45. 45.
    Siu, Y.P., Leung, K.L., Tong, M.K.H., et al. Use of allopurinol in slowing the progression of renal disease through its ability to lower the uric acid level. Am. J. Kidney Dis. 2006; 47:51–59.PubMedCrossRefGoogle Scholar
  46. 46.
    DCCT Research Group. The effect of intensive diabetes treatment on the development and progression of long-term complications in insulin-dependent diabetes mellitus the Diabetes Control and Complications Trial. N. Engl. J. Med. 1993; 329:978–986.Google Scholar
  47. 47.
    UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352:837–853.Google Scholar
  48. 48.
    Stratton, I.M., Adler, A.I., Neil, A.W., et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study. Br. Med. J. 2000; 12:405–412.CrossRefGoogle Scholar
  49. 49.
    Resnick, H.E., Foster, G.L., Bardsley, J., et al. Achievement of American Diabetes Association clinical practice recommendations among U.S. adults with diabetes, 1999–2002, the National Health and Nutrition Examination Survey. Diabetes Care 2006; 29:531–537.PubMedCrossRefGoogle Scholar
  50. 50.
    Roth, D., Smith, R.D., Schulman, G., et al. Effects of recombinant human erythropoietin on renal function in chronic renal failure predialysis patients. Am. J. Kidney Dis. 1994; 24:777–784.PubMedGoogle Scholar
  51. 51.
    Kuriyama, S., Tomonari, H., Yoshida, H., et al. Reversal of anemia by erythropoietin therapy retards the progression of chronic renal failure, especially in nondiabetic patients. Nephron 1997; 77:176–185.PubMedGoogle Scholar
  52. 52.
    Gouva, C., Nikolopoulos, P., Ioannidis, P., et al. Treating anemia early in renal failure patients slows the decline in renal function: A randomized controlled trial. Kidney Int. 2004; 66:753–760.PubMedCrossRefGoogle Scholar
  53. 53.
    Rossert, J., Levin, A., Roger, S.D., et al. Effect of early correction of anemia on the progression of CKD. Am. J. Kidney Dis. 2006; 47:738–750.PubMedCrossRefGoogle Scholar
  54. 54.
    Orth, S.R. Effects of smoking on systemic and intrarenal hemodynamics: Influence on renal function. J. Am. Soc. Nephrol. 2004; 15:S58–63.Google Scholar
  55. 55.
    Stengel, B., Couchoud, C., Cenee, S., et al. Age, blood pressure and smoking effects on chronic renal failure in primary glomerular nephropathies. Kidney Int. 2000; 57:2519–2526.PubMedGoogle Scholar
  56. 56.
    Fox, C.S., Larson, M.G., Leip, E.P., et al. Predictors of new-onset kidney disease in a community-based population. JAMA 2004; 291:844–850.PubMedCrossRefGoogle Scholar
  57. 57.
    Hsu, C.Y., McCulloch, C.E., Iribarren, et al. Body mass index and risk for end-stage renal disease. Ann. Intern. Med. 2006; 144:21–28.Google Scholar
  58. 58.
    Bosma, R.J., Krikken, J.A., van der Heide, H., et al. Obesity and renal hemodynamics. Contrib. Nephrol. 2006; 151:184–202.PubMedCrossRefGoogle Scholar
  59. 59.
    Israni, A., Korzelius, C., Townsend, R., et al. Management of chronic kidney disease in an academic primary care clinic. Am. J. Nephrol. 2003; 23:47–54.PubMedCrossRefGoogle Scholar
  60. 60.
    Kingswood, J.C., Banks, R.A., Tribe, C.R., et al. Renal biopsy in the elderly: Clinicopathologic correlations in 143 patients. Clin. Nephrol. 1984; 22:183–187.PubMedGoogle Scholar

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© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Jordan L. Rosenstock
  • Michael F. Michelis

There are no affiliations available

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