scholarly journals Rate of Kidney Function Decline in Older Adults: A Comparison Using Creatinine and Cystatin C

2009 ◽  
Vol 30 (3) ◽  
pp. 171-178 ◽  
Author(s):  
Michael G. Shlipak ◽  
Ronit Katz ◽  
Bryan Kestenbaum ◽  
Linda F. Fried ◽  
Anne B. Newman ◽  
...  
2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1015-1015
Author(s):  
Nicholas Bishop ◽  
Jie Zhu

Abstract Objectives Cystatin C (Cys C) is a promising biomarker for early-stage chronic kidney disease. Dietary intake plays an essential role in the prevention of kidney function decline, which has yet to be examined in relation to changes in Cys C among older adults. Our objective was to test whether scores on the Alternative Healthy Eating Index-2010 (AHEI-2010) were associated with change in Cys C from 2012–2016 and if this varied by race/ethnicity. Methods Observations were drawn from the Health and Retirement Study. Blood spot collection and examination occurred in 2012 and 2016, participant attributes were measured in 2012, and dietary assessment was conducted by a validated dietary frequency questionnaire in 2013. The sample was restricted to respondents aged ≥65 years who were White (n = 789), Black (n = 108), or Hispanic (n = 61) and had biomarkers measured in 2012 and 2016 (n = 958). Serum Cys C (mg/L) was constructed to be equivalent to the 1999–2002 NHANES scale. Dietary quality was measured using AHEI-2010. Autoregressive linear modeling adjusting for covariates and sampling design was used to examine the associations of interest. Results Mean serum Cys C was 1.20 ± 0.44 mg/L (SD) in 2012 and 1.25 ± 0.45 mg/L in 2016, and mean AHEI-2010 score was 58.11 ± 11.0. Greater AHEI-2010 was associated with lower serum Cys C level at baseline (b = −.004, SE = .013, P = .002) and less rapid increase in the Cys C level from 2012–2016 (b = −.003, SE = .012, P = .024). The association between AHEI-2010 and change in serum Cys C was significantly different for Whites and Hispanics (b = .128, SE = .031, P < .001), but null when comparing Whites and Blacks. AHEI-2010 was negatively associated with change in Cys C for Whites, and positively associated with change in Cys C among Hispanics. Stratified analyses suggested that AHEI-2010 was not significantly different for Whites and Hispanics. Hispanics had significantly lower household income, assets, and educational attainment than Whites, and greater levels of food insecurity. Conclusions Our results indicate that dietary quality has a divergent association with change in serum Cys C for White and Hispanic older adults. These results suggest the need for examination of how disparities in socioeconomic status may influence the effect of dietary intake on kidney function for older adults from different racial/ethnic backgrounds. Funding Sources No funding.


Author(s):  
Keiko Kabasawa ◽  
Kazutoshi Nakamura ◽  
Yumi Ito ◽  
Junta Tanaka ◽  
Ichiei Narita

Abstract Background Kidney dysfunction is associated with sarcopenia. Estimated glomerular filtration rate based on cystatin C (eGFRcys), an alternative to creatinine-based measures of kidney function eGFR, is not affected by muscle mass. Given that the association of eGFRcys with muscle weakness would be limited, we examined the association in older adults with normal or compromised kidney function. Methods This cross-sectional study involved 594 community-dwelling Japanese adults aged ≥40 years living in Yuzawa, Japan. Serum creatinine, cystatin C, and handgrip strength were concurrently measured at a health-check examination in 2015. eGFR was calculated according to the equation developed for the Japanese population using creatinine and cystatin C. Associations of eGFRcys and eGFRcreat with low grip strength (men, <26 kg and women, <18 kg) were analyzed using logistic regression models adjusted to control for potential confounders. Results Participants (mean age, 74.9 years) included 319 women and 109 individuals with low grip strength. Mean eGFRcys was 75.2 (SD 18.6) mL/min/1.73 m2. Pearson’s correlation coefficients of handgrip strength for eGFRcys and eGFRcreat were 0.19 (p < .001) and −0.04 (p = .281), respectively. Multivariate logistic regression analysis showed the adjusted odds ratio (OR) of low grip strength for the highest versus lowest quartile of eGFRcys value was 2.46 (95% confidence interval, 1.03–5.86; p-trend = .026); whereas the comparative adjusted OR for eGFRcreat was 0.67 (95% confidence interval, 0.34–1.32). Conclusions Low kidney function as assessed by eGFRcys was associated with muscle weakness in community-dwelling Japanese older adults.


2008 ◽  
Vol 168 (20) ◽  
pp. 2212 ◽  
Author(s):  
Dena E. Rifkin ◽  
Michael G. Shlipak ◽  
Ronit Katz ◽  
Linda F. Fried ◽  
David Siscovick ◽  
...  

2018 ◽  
Vol 47 (4) ◽  
pp. 242-250 ◽  
Author(s):  
David A. Drew ◽  
Ronit Katz ◽  
Stephen Kritchevsky ◽  
Joachim H. Ix ◽  
Michael G. Shlipak ◽  
...  

Background: Fibroblast growth factor 23 (FGF-23) is a hormone that regulates phosphorus levels and vitamin D metabolism. Previous studies have shown FGF-23 to be a risk factor for incident end-stage renal disease; however, there are less data on the association of FGF-23 with earlier kidney-related outcomes. Methods: Serum FGF-23 was assayed using an intact ELISA assay in 2,496 participants of the Healthy Aging and Body Composition Study, a cohort of well-functioning older adults. Kidney function was estimated by assaying cystatin C at baseline and years 3 and 10. The associations between FGF-23 and decline in kidney function (defined by estimated glomerular filtration rate (eGFR) decline ≥30% or ≥3 mL/min/year) and incident chronic kidney disease (CKD; incident eGFR <60 mL/min/1.73 m2 and ≥1 mL/min/year decline) were evaluated. Models were adjusted for demographics, baseline eGFR, urine albumin/creatinine ratio, comorbidity, and serum calcium, phosphorus, 25(OH) vitamin D and parathyroid hormone. Results: The mean (SD) age was 75 (3) years, with 52% female and 38% black. There were 405 persons with 30% decline, 702 with >3 mL/min/year decline, and 536 with incident CKD. In fully adjusted continuous models, doubling of FGF-23 concentrations was not associated with kidney function decline (OR [95% CI] = 0.98 [0.82–1.19] for ≥30% decline and OR 1.17 [95% CI 1.00–1.37] for ≥3 mL/min/year decline), or incident CKD (incident rate ratio [IRR] 1.05 [95% CI 0.91–1.22]). In adjusted quartile analysis, the highest quartile of FGF-23 was significantly associated with incident CKD (IRR 1.27 [95% CI 1.02–1.58] for highest vs. lowest quartile). Conclusion: Higher FGF-23 concentrations were not consistently associated with decline in kidney function or incident CKD in community-dwelling older adults.


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