Rifkin et al evaluated the decline in renal function over time in older adults. A rapid decline in renal function is associated with a greater risk for mortality. The authors are from multiple universities in the United States.
Patient selection: >= 65 years of age
Renal function was expressed using cystatin-based estimates of GFR in mL per minute per 1.73 square meters.
rate of change in GFR per year =
= (change in GFR) / (time interval between measurements in years)
where:
• In Excel the dates of GFR measurent can be subtracted with the value in days.
Interpretation:
• The “normal” decline in eGFR is <= 1 mL per min per 1.73 square meter per year.
• A decline >= 3 mL per min per square meter per year was termed a “rapid” decline.
• The hazard rate for all cause mortality was about 1 when the decline was 3 mL per min per 1.73 square meter per year. The hazard ratio was around 2 for a decline of 6 mL per min per 1.73 square meter per year.
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