Journal of Internal Medicine Concepts & Practice >

2025 , Vol. 20 >Issue 02: 132 - 139

DOI: https://doi.org/10.16138/j.1673-6087.2025.02.06

Original article

Predictive effect of estimated glomerular filtration rate on clinical prognosis of elderly hospitalized patients

  • ZHANG Xiaoyan ,
  • XU Jing ,
  • QU Bin
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  • a. Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025,China
    b. Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025,China
    c. Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025,China

Received date: 2024-03-18

  Online published: 2025-07-08

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Abstract

Objective To investigate the association of several commonly used estimated glomerular filtration rate (eGFR) formula and urinary albumin to creatinine ratio (UACR) with cardiovascular events, renal endpoint events, and mortality in an elderly population.Methods The patients aged ≥ 65 who were treated and had follow-up data more than 1 year in the Department of Geriatrics of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2015 to December 2018 were selected. Logistic regression analyses were used to evaluate the association of eGFR derived by chronic kidney disease epidemiology collaboration(CKD-EPI) creatinine（Cr） formula (CKD-EPICr), CKD-EPI cystatin C formula( CKD-EPICys), the racially neutral CKD-EPICr-Cys formula and Berlin Initiative Study (BIS) formula 2 (based on Cr and cystatin C) with prognosis.Results Totally 475 elderly patients were recruited with a median age of 83(76-87) years and a follow-up time of 76(68-91) months. Before adjustment, those with a decreased eGFR[<60 mL/(min·1.73 m2)] had a higher risk of death when eGFR estimated by CKD-EPICys, CKD-EPICr-Cys, and BIS2, but the association was negative after adjusting by multiple covariates. Before adjustment, those with a decreased eGFR by all equations had a significantly higher risk of cardiovascular events. The odds ratio was highest for eGFR estimated by BIS2. After adjusting for gender, age, and past medical history, the association remains statistically significant between eGFR estimated by BIS2 and cardiovascular events(P=0.038). After adjusting for gender, age, and past medical history, the risk of renal endpoint events was higher in those with decreased eGFR estimated by CKD-EPICr-Cys (P=0.023). None of the other equations showed a significant correlation with renal endpoint events. Before adjustment, those with a decreased eGFR by all equations had a significantly higher risk of composite events. The odds ratio was highest for eGFR estimated by BIS2. After adjusting for gender and age, the association remains statistically significant between composite events and eGFR estimated by CKD-EPICr(P=0.030) fit without race, CKD-EPICys (P=0.044) and BIS2(P=0.034). After multivariate adjustment, those with UACR ≥ 30 mg/g had a significantly higher risk of death, cardiovascular events, renal endpoint events, and composite endpoints compared with those with UACR < 30 mg/g. Elevated UACR was more strongly associated with outcomes than decreased eGFR but not with renal endpoint events.Conclusions Elevated UACR was strongly associated with death, cardiovascular events, and composite endpoints. Among different eGFR formations, decreased eGFR using BIS2 was more strongly associated with cardiovascular events, whereas CKD-EPICr-Cys was more strongly associated with renal endpoint events.

Key words： Elderly people; Estimated glomerular filtration rate; Renal function; Urinary albumin to creatinine; Clinical prognosis

Cite this article

ZHANG Xiaoyan , XU Jing , QU Bin . Predictive effect of estimated glomerular filtration rate on clinical prognosis of elderly hospitalized patients[J]. Journal of Internal Medicine Concepts & Practice, 2025 , 20(02) : 132 -139 . DOI: 10.16138/j.1673-6087.2025.02.06

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