UP FRONT MATTERS: Special Articles

Prediction, Progression, and Outcomes of Chronic Kidney Disease in Older Adults

Sharon Anderson ^*, Jeffrey B. Halter , William R. Hazzard , Jonathan Himmelfarb , Frances McFarland Horne ^||, George A. Kaysen ^¶, John W. Kusek ^**, Susan G. Nayfield , Kenneth Schmader , Ying Tian , John R. Ashworth ^||, Charles P. Clayton ^||, Ryan P. Parker ^||, Erika D. Tarver ^||, Nancy F. Woolard , Kevin P. High ¹, and for the workshop participants

*Department of Medicine, Oregon Health and Science University, Portland, Oregon; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Department of Medicine, University of Washington and VA Puget Sound Health Care System, Seattle, Washington; Department of Medicine, Maine Medical Center, Portland, Maine; ||Association of Specialty Professors, Washington, DC; ¶Department of Internal Medicine, University of California-Davis, Davis, California; **Kidney and Urology Branch, National Institute of Diabetes and Digestive and Kidney Diseases and Geriatrics and Clinical Gerontology Branch, National Institute on Aging, Bethesda, Maryland; and Department of Medicine, Duke University and Durham VA Medical Centers, Durham, North Carolina, and Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina

¹ To whom correspondence should be addressed. E-mail: khigh{at}wfubmc.edu.

	Abstract

Chronic kidney disease is a large and growing problem among aging populations. Although progression of chronic kidney disease to end-stage renal disease (ESRD) is a costly and important clinical event with substantial morbidity, it appears less frequently in aging people compared with cardiovascular mortality. The measurement of kidney function and management of kidney disease in older individuals remain challenging, partly because the pathophysiologic mechanisms underlying age-related decline in kidney function, the interactions between age and other risk factors in renal progression, and the associations of chronic kidney disease with other comorbidities in older people are understudied and poorly understood. The Association of Specialty Professors, the American Society of Nephrology, the American Geriatrics Society, the National Institute on Aging, and the National Institute of Diabetes and Digestive and Kidney Diseases held a workshop, summarized in this article, to review what is known about chronic kidney disease, identify research gaps and resources available to address them, and identify priority areas for future research. Answers to emerging research questions will support the integration of geriatrics and nephrology and thus improve care for older patients at risk for chronic kidney disease.