Prevalence and Associated Comorbidities of Moderate to Severe Chronic Renal Impairment in Chinese Nursing Home Older Adults

Abstract

Objective: To investigate the prevalence and associated comorbidities of Stage 3 (GFR 30-59 mL/min/1.73m 2) and Stages 4 and 5 (GFR <30 mL/min/1.73m 2) chronic kidney disease (CKD) among Chinese nursing home older adults. Design: Retrospective cross-sectional study. Glomerular filtration rate (GFR) was estimated by Modification of Diet in Renal Disease Study (Chinese-adjusted) equation and The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Setting: Nine nursing homes in Hong Kong. Participants: Participants included 812 nursing home older adults (271 men and 571 women), mean age 86.0±7.6. Measurements: Prevalence of Stage 3 (GFR 30-59 mL/min/1.73m 2) and Stages 4 and 5 (GFR <30 mL/min/1.73m 2) CKD. The comorbidities associated with renal impairment were also assessed. Results: There were 18.4% of nursing home older adults who had elevated serum creatinine levels above the normal limits. Using Modification of Diet in Renal Disease Study and CKD-EPI equations, 26.4% and 21.2% of them had Stage 3 CKD, whereas 6.8% and 4.4% had Stage 4-5 CKD, respectively. Diabetes mellitus, hypertension, congestive heart failure, and ischemic heart disease correlated significantly with moderate to severe renal impairment in Chinese nursing home older adults. Conclusion: Stages 3 to 5 CKD are prevalent in Chinese nursing home older adults. Early identification of these patients facilitates drug prescription, renal management, and advance care planning. © 2012 American Medical Directors Association.