184
Chronic Kidney Disease in the Elderly
Aging is associated with a progressive decrease in glomerular filtration rate. Indeed,
the “physiological” loss of glomerular filtration rate has been quantified as a loss of
1 ml/min per year. However, the rate of loss of glomerular filtration rate is very vari-
able: some individuals display stable glomerular filtration rate over the years, while
some lose glomerular filtration rate at a faster rate and develop chronic kidney dis-
ease [ 3 ].
In this regard, the prevalence of chronic kidney disease increases with age
(Fig. 12.2) [ 4 ]. Most elderly individuals with chronic kidney disease have not been
diagnosed. However, the prevalence of chronic kidney disease is around 60% for
those aged 80 years or older. Thus, population studies in such elderly individuals
4.6 7.2 9.4
65-7 47 5-79 >– 80
%
years yearsyears
% %
60
37 % 48 % %
A) Known CKD
B) Unknown CKD
Fig. 12.1 Chronic kidney
disease: underdiagnosed in
the elderly (Elaborated
from data obtained from
Stevens et al. [ 4 ]). (A)
Percentage of individuals
with known CKD. (B)
Percentage of individuals
with undiagnosed CKD
Spanish r
esiden
ts
85-year-
old or
older (number)
0
200000
400000
600000
800000
1000000
1200000
1400000
2002 2015
Fig. 12.2 The elderly population is rapidly increasing (Elaborated with official data from the
Spanish National Statistics Institute (Instituto Nacional de Estadística, INE) [ 23 ])
R. Fernández-Prado et al.