2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2005090902v1 17/9/2561    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van Bemmel, T. Articles by Gussekloo, J. Search for Related Content PubMed PubMed Citation Articles by van Bemmel, T. Articles by Gussekloo, J. Related Collections Related Article

Prospective Study of the Effect of Blood Pressure on Renal Function in Old Age: The Leiden 85-Plus Study

Thomas van Bemmel^*, Karen Woittiez, Gerard J. Blauw^*, Femke van der Sman-de Beer, Friedo W. Dekker, Rudi G.J. Westendorp^* and Jacobijn Gussekloo

Departments of ^* Gerontology and Geriatrics, Clinical Epidemiology, and Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands

Address correspondence to: Dr. Gerard J. Blauw, Department of Gerontology and Geriatrics, C2-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. Phone: +31-71-5266640; Fax: +31-71-5248159; E-mail: g.j.blauw{at}lumc.nl

Received for publication September 2, 2005. Accepted for publication June 28, 2006.

High BP is associated with decline of renal function. Whether this is true for very old people largely is unknown. Therefore, this study assessed the effect of BP on creatinine clearance over time in very old participants. A total of 550 inhabitants (34% men) of Leiden, The Netherlands, were enrolled in a population-based study at their 85th birthday and followed until death or age 90. BP was measured twice at baseline and at age 90 yr. Creatinine clearance was estimated annually (Cockcroft-Gault formula). The mean creatinine clearance at baseline was 45.4 ml/min (SD 11.5). Systolic BP was not associated with changes in creatinine clearance during follow-up. Those with diastolic BP (DBP) <70 mmHg had an accelerated decline of creatinine clearance (1.63 ml/min per yr) compared with those with DBP between 70 and 79 mmHg (1.21 ml/min per yr; P = 0.01), 80 to 89 mmHg (1.26 ml/min per yr; P = 0.03), and >89 mmHg (1.38 ml/min per yr; P = 0.32). Participants with a decline in systolic BP during follow-up had an accelerated decline of creatinine clearance compared with those with stable BP (1.54 [SE 0.09] versus 0.98 ml/min per yr [SE 0.09]; P < 0.001). Similar results were found for a decline in DBP (1.54 [SE 0.10] versus 1.06 ml/min per yr [SE 0.08]; P < 0.001). In the oldest individual, high BP is not associated with renal function. In contrast, low DBP is associated with an accelerated decline of renal function. The clinical implications of these findings have to be studied.

Related Article

This Month’s Highlights
J. Am. Soc. Nephrol. 2006 17: 2343-2344. [Full Text] [PDF]

This article has been cited by other articles:

				A. M. Saran and T. D. DuBose Jr Cardiovascular disease in chronic kidney disease Therapeutic Advances in Cardiovascular Disease, December 1, 2008; 2(6): 425 - 434. [Abstract] [PDF]

				N. S. Beckett, R. Peters, A. E. Fletcher, J. A. Staessen, L. Liu, D. Dumitrascu, V. Stoyanovsky, R. L. Antikainen, Y. Nikitin, C. Anderson, et al. Treatment of Hypertension in Patients 80 Years of Age or Older N. Engl. J. Med., May 1, 2008; 358(18): 1887 - 1898. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673