The evolution of renal function and the incidence of end-stage renal disease in patients aged >= 50 years

Background. The prevalence of chronic kidney disease (CKD) is high, especially among older patients. Methods. In order to identify risk factors for the evolution towards end-stage renal disease (ESRD), a cohort of patients >= 50 years of age for whom at least four serum creatinine measurements were available were selected from a primary care-based database. The slope of changes in estimated glomerular filtration rate (eGFR) (using the Modification of Diet in Renal Disease formula) was calculated, and ESRD was defined as eGFR = 80 years compared with patients aged 50-64 years). Females (HR = 1.48) and patients with diabetes (HR = 1.20), hypertension (HR = 1.25), high total cholesterol (HR = 1.28) or high low-density lipoprotein (LDL) cholesterol (HR = 1.39) were at higher risk for ESRD. Conclusions. Baseline eGFR, diabetes, high cholesterol, high LDL, hypertension and female gender are independent risk factors for developing ESRD. Older age at baseline predicts a lower risk.