Chronic kidney disease as a predictor of clinical risk in the elderly

Facing the needs of an increasingly ageing population is rapidly becoming a major public health issue in western countries.[1],[2] Chronic kidney disease (CKD), whose current prevalence is estimated around 10%−15% in the general population, with considerably higher figures in at-risk groups, is widely known to increase with age.[3] In the elderly, renal impairment is often concomitant or secondary to several other systemic disorders such as hypertension, atherosclerosis, diabetes and cardiovascular (CV) diseases. As accurate clinical risk assessment is a prerequisite for devising effective preventive and therapeutic strategies, identifying and enhancing the presence of renal abnormalities is an important step to effectively deal with the frail patient with comorbidities. Glomerular filtration rate (GFR) and albuminuria, the two main components of CKD, have been shown to be independent and strong predictors of CV morbidity and mortality and all-cause mortality in the general population as well as in the elderly.[3] We will briefly review data from the literature supporting the role of renal parameters as practical, low cost and efficient tools for a comprehensive risk assessment in the elderly and will argue in favor of a wider use of these tests in different clinical settings from general practice to specialized hospital centres.