The epidemic of chronic kidney disease: Looking at ageing and cardiovascular disease through kidney-shaped lenses

F. Mangione, A. Dal Canton

Research output: Contribution to journalArticle

Abstract

In recent years, a 'silent' chronic kidney disease (CKD) epidemic has been proposed by many authors. The 'outbreak' is because of the inclusion of a large proportion of the elderly population within stage 3 CKD according to the Kidney Disease Outcomes Quality Initiative staging system. Unfortunately, this does not take into account the fact that renal function normally declines with age; in addition, the Modification of Diet in Renal Disease formula used to calculate glomerular filtration rate underestimates renal function in the elderly. Because population preventive strategies need a precise definition of the target for screening, a more accurate tool to detect CKD in the general population is required. Considerable interest in CKD has been generated by the evidence that predialysis CKD is associated with increased risk of cardiovascular disease (CVD). Such an association per se does not imply that CKD is a causal determinant of CVD. As CKD has been detected particularly in elderly individuals, it is tempting to speculate that an association may exist between age and cardiovascular outcomes in patients with CKD. Furthermore, the definition of CKD is a nosographic simplification that includes diseases with different causes and pathogenetic mechanisms. The aetiologies of renal diseases can affect cardiovascular outcomes, and the two major causes of end-stage renal disease, diabetes mellitus and hypertension, indeed do so. These findings point to a need for a better definition of CKD to optimize the allocation of healthcare resources and to clarify the nature of the association between CKD and CVD.

Original languageEnglish
Pages (from-to)449-455
Number of pages7
JournalJournal of Internal Medicine
Volume268
Issue number5
DOIs
Publication statusPublished - Nov 2010

Fingerprint

Chronic Renal Insufficiency
Lenses
Cardiovascular Diseases
Kidney
Population
Diet Therapy
Resource Allocation
Kidney Diseases
Glomerular Filtration Rate
Chronic Kidney Failure
Disease Outbreaks
Diabetes Mellitus
Hypertension
Delivery of Health Care

Keywords

  • Ageing
  • Atherosclerosis
  • Cardiovascular disease
  • Chronic kidney disease

ASJC Scopus subject areas

  • Internal Medicine

Cite this

The epidemic of chronic kidney disease : Looking at ageing and cardiovascular disease through kidney-shaped lenses. / Mangione, F.; Canton, A. Dal.

In: Journal of Internal Medicine, Vol. 268, No. 5, 11.2010, p. 449-455.

Research output: Contribution to journalArticle

@article{15ea028e6b6e41c5b61758d7d91246b3,
title = "The epidemic of chronic kidney disease: Looking at ageing and cardiovascular disease through kidney-shaped lenses",
abstract = "In recent years, a 'silent' chronic kidney disease (CKD) epidemic has been proposed by many authors. The 'outbreak' is because of the inclusion of a large proportion of the elderly population within stage 3 CKD according to the Kidney Disease Outcomes Quality Initiative staging system. Unfortunately, this does not take into account the fact that renal function normally declines with age; in addition, the Modification of Diet in Renal Disease formula used to calculate glomerular filtration rate underestimates renal function in the elderly. Because population preventive strategies need a precise definition of the target for screening, a more accurate tool to detect CKD in the general population is required. Considerable interest in CKD has been generated by the evidence that predialysis CKD is associated with increased risk of cardiovascular disease (CVD). Such an association per se does not imply that CKD is a causal determinant of CVD. As CKD has been detected particularly in elderly individuals, it is tempting to speculate that an association may exist between age and cardiovascular outcomes in patients with CKD. Furthermore, the definition of CKD is a nosographic simplification that includes diseases with different causes and pathogenetic mechanisms. The aetiologies of renal diseases can affect cardiovascular outcomes, and the two major causes of end-stage renal disease, diabetes mellitus and hypertension, indeed do so. These findings point to a need for a better definition of CKD to optimize the allocation of healthcare resources and to clarify the nature of the association between CKD and CVD.",
keywords = "Ageing, Atherosclerosis, Cardiovascular disease, Chronic kidney disease",
author = "F. Mangione and Canton, {A. Dal}",
year = "2010",
month = "11",
doi = "10.1111/j.1365-2796.2010.02289.x",
language = "English",
volume = "268",
pages = "449--455",
journal = "Journal of Internal Medicine",
issn = "0954-6820",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - The epidemic of chronic kidney disease

T2 - Looking at ageing and cardiovascular disease through kidney-shaped lenses

AU - Mangione, F.

AU - Canton, A. Dal

PY - 2010/11

Y1 - 2010/11

N2 - In recent years, a 'silent' chronic kidney disease (CKD) epidemic has been proposed by many authors. The 'outbreak' is because of the inclusion of a large proportion of the elderly population within stage 3 CKD according to the Kidney Disease Outcomes Quality Initiative staging system. Unfortunately, this does not take into account the fact that renal function normally declines with age; in addition, the Modification of Diet in Renal Disease formula used to calculate glomerular filtration rate underestimates renal function in the elderly. Because population preventive strategies need a precise definition of the target for screening, a more accurate tool to detect CKD in the general population is required. Considerable interest in CKD has been generated by the evidence that predialysis CKD is associated with increased risk of cardiovascular disease (CVD). Such an association per se does not imply that CKD is a causal determinant of CVD. As CKD has been detected particularly in elderly individuals, it is tempting to speculate that an association may exist between age and cardiovascular outcomes in patients with CKD. Furthermore, the definition of CKD is a nosographic simplification that includes diseases with different causes and pathogenetic mechanisms. The aetiologies of renal diseases can affect cardiovascular outcomes, and the two major causes of end-stage renal disease, diabetes mellitus and hypertension, indeed do so. These findings point to a need for a better definition of CKD to optimize the allocation of healthcare resources and to clarify the nature of the association between CKD and CVD.

AB - In recent years, a 'silent' chronic kidney disease (CKD) epidemic has been proposed by many authors. The 'outbreak' is because of the inclusion of a large proportion of the elderly population within stage 3 CKD according to the Kidney Disease Outcomes Quality Initiative staging system. Unfortunately, this does not take into account the fact that renal function normally declines with age; in addition, the Modification of Diet in Renal Disease formula used to calculate glomerular filtration rate underestimates renal function in the elderly. Because population preventive strategies need a precise definition of the target for screening, a more accurate tool to detect CKD in the general population is required. Considerable interest in CKD has been generated by the evidence that predialysis CKD is associated with increased risk of cardiovascular disease (CVD). Such an association per se does not imply that CKD is a causal determinant of CVD. As CKD has been detected particularly in elderly individuals, it is tempting to speculate that an association may exist between age and cardiovascular outcomes in patients with CKD. Furthermore, the definition of CKD is a nosographic simplification that includes diseases with different causes and pathogenetic mechanisms. The aetiologies of renal diseases can affect cardiovascular outcomes, and the two major causes of end-stage renal disease, diabetes mellitus and hypertension, indeed do so. These findings point to a need for a better definition of CKD to optimize the allocation of healthcare resources and to clarify the nature of the association between CKD and CVD.

KW - Ageing

KW - Atherosclerosis

KW - Cardiovascular disease

KW - Chronic kidney disease

UR - http://www.scopus.com/inward/record.url?scp=77958547973&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77958547973&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2796.2010.02289.x

DO - 10.1111/j.1365-2796.2010.02289.x

M3 - Article

C2 - 20964736

AN - SCOPUS:77958547973

VL - 268

SP - 449

EP - 455

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

SN - 0954-6820

IS - 5

ER -