Among elderly patients with CKD, female gender and lower estimated glomerular filtration rate (eGFR) predict a higher risk of progressing to end-stage renal disease (ESRD), whereas male gender and a history of peripheral vascular disease are associated with an increased likelihood of death, according to a study.
Patients who progressed to ESRD had a lower calcium and higher phosphorus, parathyroid hormone, and urinary protein levels at baseline.
Maria Marin, MD, of St. John Hospital and Medical Center in Detroit, and colleagues retrospectively examined the charts of patients older than 65 years who had an eGFR of 15-45 mL/min/1.73 m2 at study inclusion. The researchers defined CKD as a persistent decrease in eGFR to below 60 over three months.
The study included 198 patients (117 female, 81 male) with an average age of 75.6 years and average eGFR of 30. The group included 149 whites and 48 blacks.
After a mean follow-up of 39.9 months, 18 patients died and 19 progressed to ESRD. The eGFR at baseline was significantly lower in patients who progressed to ESRD than in those who died or subjects without an endpoint (22.1 vs. 28.2 vs. 31.2, respectively). The death rate among men was higher than among women (14.8% vs. 5.1%). In addition, 11.1% of women progressed to ESRD compared with 7.4% of men. Patients who had CKD as a result of diabetes experienced significantly more rapid loss of eGFR and were significantly more likely to progress to ESRD than patients with other causes of CKD, the researchers reported.