Prevalence and associated comorbidities of moderate to severe chronic renal impairment in Chinese nursing home older adults

J Am Med Dir Assoc. 2012 Sep;13(7):630-3. doi: 10.1016/j.jamda.2012.05.007. Epub 2012 Jun 13.

Abstract

Objective: To investigate the prevalence and associated comorbidities of Stage 3 (GFR 30-59 mL/min/1.73m(2)) and Stages 4 and 5 (GFR <30 mL/min/1.73m(2)) chronic kidney disease (CKD) among Chinese nursing home older adults.

Design: Retrospective cross-sectional study. Glomerular filtration rate (GFR) was estimated by Modification of Diet in Renal Disease Study (Chinese-adjusted) equation and The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations.

Setting: Nine nursing homes in Hong Kong

Participants: Participants included 812 nursing home older adults (271 men and 571 women), mean age 86.0 ± 7.6.

Measurements: Prevalence of Stage 3 (GFR 30-59 mL/min/1.73m(2)) and Stages 4 and 5 (GFR <30 mL/min/1.73m(2)) CKD. The comorbidities associated with renal impairment were also assessed.

Results: There were 18.4% of nursing home older adults who had elevated serum creatinine levels above the normal limits. Using Modification of Diet in Renal Disease Study and CKD-EPI equations, 26.4% and 21.2% of them had Stage 3 CKD, whereas 6.8% and 4.4% had Stage 4-5 CKD, respectively. Diabetes mellitus, hypertension, congestive heart failure, and ischemic heart disease correlated significantly with moderate to severe renal impairment in Chinese nursing home older adults.

Conclusion: Stages 3 to 5 CKD are prevalent in Chinese nursing home older adults. Early identification of these patients facilitates drug prescription, renal management, and advance care planning.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Female
  • Glomerular Filtration Rate
  • Heart Failure / epidemiology
  • Hong Kong / epidemiology
  • Humans
  • Hypertension / epidemiology
  • Male
  • Myocardial Ischemia / epidemiology
  • Nursing Homes
  • Prevalence
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / physiopathology
  • Retrospective Studies
  • Severity of Illness Index