0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

The Association Between Age and Nephrosclerosis on Renal Biopsy Among Healthy Adults

Andrew D. Rule, MD, MSc; Hatem Amer, MD; Lynn D. Cornell, MD; Sandra J. Taler, MD; Fernando G. Cosio, MD; Walter K. Kremers, PhD; Stephen C. Textor, MD; and Mark D. Stegall, MD
[+] Article and Author Information

From Mayo Clinic, Rochester, Minnesota.


Grant Support: By National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (grant K23 DK078229).

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M09-2223.

Reproducible Research Statement:Study protocol, statistical code, and data set: Not available.

Requests for Single Reprints: Andrew D. Rule, MD, MSc, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905.

Current Author Addresses: Drs. Rule, Amer, Cornell, Taler, Cosio, Kremers, Textor, and Stegall: Mayo Clinic, 200 1st Street SW, Rochester, MN 55905.

Author Contributions: Conception and design: A.D. Rule, L.D. Cornell, S.J. Taler.

Analysis and interpretation of the data: A.D. Rule, L.D. Cornell, S.J. Taler, F.G. Cosio, W.K. Kremers, S.C. Textor, M.D. Stegall.

Drafting of the article: A.D. Rule, M.D. Stegall.

Critical revision of the article for important intellectual content: A.D. Rule, H. Amer, L.D. Cornell, S.J. Taler, F.G. Cosio, W.K. Kremers, S.C. Textor, M.D. Stegall.

Final approval of the article: A.D. Rule, H. Amer, L.D. Cornell, F.G. Cosio, S.C. Textor, M.D. Stegall.

Provision of study materials or patients: A.D. Rule, H. Amer, S.J. Taler, S.C. Textor, M.D. Stegall.

Statistical expertise: A.D. Rule, W.K. Kremers.

Obtaining of funding: A.D. Rule.

Administrative, technical, or logistic support: A.D. Rule, H. Amer, F.G. Cosio, M.D. Stegall.

Collection and assembly of data: A.D. Rule, H. Amer, L.D. Cornell, F.G. Cosio, S.C. Textor, M.D. Stegall.


Ann Intern Med. 2010;152(9):561-567. doi:10.7326/0003-4819-152-9-201005040-00006
Text Size: A A A

Background: Chronic kidney disease is common with older age and is characterized on renal biopsy by global glomerulosclerosis, tubular atrophy, interstitial fibrosis, and arteriosclerosis.

Objective: To see whether the prevalence of these histologic abnormalities in the kidney increases with age in healthy adults and whether histologic findings are explained by age-related differences in kidney function or chronic kidney disease risk factors.

Design: Cross-sectional study.

Setting: Mayo Clinic, Rochester, Minnesota, from 1999 to 2009.

Patients: 1203 adult living kidney donors.

Measurements: Core-needle biopsy of the renal cortex obtained during surgical implantation of the kidney, and medical record data of kidney function and risk factors obtained before donation.

Results: The prevalence of nephrosclerosis (≥2 chronic histologic abnormalities) was 2.7% (95% CI, 1.1% to 6.7%) for patients aged 18 to 29 years, 16% (CI, 12% to 20%) for patients aged 30 to 39 years, 28% (CI, 24% to 32%) for patients aged 40 to 49 years, 44% (CI, 38% to 50%) for patients aged 50 to 59 years, 58% (CI, 47% to 67%) for patients aged 60 to 69 years, and 73% (CI, 43% to 90%) for patients aged 70 to 77 years. Adjustment for kidney function and risk factor covariates did not explain the age-related increase in the prevalence of nephrosclerosis.

Limitation: Kidney donors are selected for health and lack the spectrum or severity of renal pathologic findings in the general population.

Conclusion: Kidney function and chronic kidney disease risk factors do not explain the strong association between age and nephrosclerosis in healthy adults.

Primary Funding Source: National Institutes of Health, U.S. Public Health Service.

Figures

Grahic Jump Location
Figure.
The relationship between GFR and age in persons with and without nephrosclerosis.

Regression of GFR onto age in persons with nephrosclerosis (solid black line) is similar to that in persons without nephrosclerosis (solid green line). Dashed lines represent the 95% CIs. GFR = glomerular filtration rate.

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)