| Objective: This goal of the study is to analyze the differences in estimated glomerular filtration rate (eGFR) calculated using different equations for the elderly patients in a large medical center. Meanwhile, to analyze changes in kidney function and its correlation with nutritional metabolism indicators in hospitalized elderly patients in a large medical center over the past 7 years.Methods: STDY.1, A cross-sectional study was conducted to analyze the renal function of 49,828 patients over 60 years of age hospitalized in the Chinese People’s Liberation Anny (PLA) General Hospital in 2014. eGFR is calculated using 5 evaluation formula: Chronic kidney disease-epidemiology collaboration equation(EPI equation) , IDMS traceable modification of diet in renal diseas equation (MDRD equation ) , MDRD equation for Japanese ( MDRDjap equation ) , MDRD equation for Chinese ( MDRDChi equation) , Berlin Initiative Study equation (BIS equation).STDY.2, The renal function of patients more than 60 years in the PLA General Hospital in 2008, 2011, and 2014 were comparatively analyzed. The hemoglobin,serum albumin, triglycerides, cholesterol, uric acid, and urea nitrogen data were collected and used as the nutritional metabolism indicators of them; in addition, the correlation between these indicators and the eGFR was analyzed.Results: STDY.1, The total number of data samples was 49,828, mean age 69.45± 7.74 years, the median serum creatinine: male 77.5μmol / L and female 62.1μmol /L. The proportion of eGFR below 60ml / min using EPI equation: male 60-69 years old 8.6%, 70-79 years old 17.9%, 80-89 years old 34.2%, over 90 years old 52.4%;female, 60-69 years old 8.8%, 70-79 years 19.2%, 70-79 years 40.8%, 90 years old and above 48.0%. The median of eGFR calculated by each formula was 86.9 mL/min/1.73m2 ( EPI ) , 86.3 mL/min/1.73m2 ( IDMS traceable MDRD ) , 67.6 mL/min/1.73m2 ( MDRDJap ),96.6 mL/min/1.73m2 ( MDRDChi),76.1 mL/min/1.73m2(BIS ) in male; 86.9 mL/min/1.73m2 ( EPI), 83.0 mL/min/1.73m2 (IDMS traceable MDRD ), 63.7 mL/min/1.73m2( MDRDJap), 100.6mL/min/1.73m2( MDRDChi), 75.7 mL/min/1.73m2 ( BIS ) in female. The expression of formulas in different age groups and different levels of eGFR showed certain differences. STDY.2 The numbers of patients who received kidney function assessments in the 3 years were 15,752, 23,539,and 49,828; their mean ages were 69.97 ± 6.99, 69.51 ± 7.11, and 69.45 ± 7.74 years.The median values of serum creatinine were 75.4, 76.5, and 77.5 μmol/L in the men and 59.6, 60.7, and 62.μmol/L in the women. The eGFR in both gender demonstrated a gradual decreasing trend over the 3 years. According to the CKD staging method,analysis of the different percentages of eGFR intervals in the patients showed that the percentages of the 3 groups with an eGFR lower than 60 mL/min/1.73m2 exhibited a rising trend annually. Correlational analysis of the nutritional indicators showed that the correlations OR between Hb, ALB, TG, TC, UA, and BUN with an eGFR lower than 60 mL/min/1.73 m2 were 0.582, 0.780, 1.219, 1.364, 2.180, and 3.677,respectively.Conclusions: The incidence of renal dysfunction was high in the elderly, with some differences among different estimation equations. It is very important to evaluate the renal function of the elderly in clinical practice, and an accurate eGFR equation for large-scale and multi-center samples is needed. Serum creatinine showed a gradually increasing trend over the 3 study years. The CKD-EPI equation calculation results showed that the eGFR in elderly people of different genders gradually decreased. Reduction of hemoglobin and albumin was a risk factor for decreased kidney function, while increases in uric acid and blood lipids affected the progression of renal insufficiency. |
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