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[email protected] 11 Review Chronic kidney disease in the elderly: evaluation and management Clin. Pract. Chronic kidney disease (CKD) is a very common clinical problem in elderly patients Mary Mallappallil1, Eli A and is associated with increased morbidity and mortality. As life expectancy continues Friedman1, Barbara G to improve worldwide, there is a rising prevalence of comorbidities and risk factors Delano1, Samy I McFarlane2 ,1 such as hypertension and diabetes predisposing to a high burden of CKD in this & Moro O Salifu* 1Division of Nephrology, SUNY population. The body of knowledge on the approach to elderly patient with CKD Downstate Medical Center, Brooklyn, is still evolving. Thus, this review seeks to explore the epidemiology and to discuss NY 11203, USA current understanding of challenges in the diagnosis and management of elderly 2Department of Endocrinology, SUNY patients CKD. Downstate Medical Center, Brooklyn, NY 11203, USA Keywords: chronic kidney disease • CKD • elderly • GFR • MDRD • old age • risk *Author for correspondence: factors • US Tel.: +1 718 270 1584 Fax: +1 718 270 3327
[email protected] Although considerable interest continues elderly with CKD, as of 2005 the Accredi- to mount on diseases of the elderly, there is tation Council for Graduate Medical Edu- no universally accepted definition of elderly cation included geriatric nephrology train- particularly in patients with chronic kidney ing in the core curriculum for nephrology disease (CKD). In 1935, the USA passed the f ellowship [6]. first Social Security Act, using age 65 years as the age of retirement and the age at which a Prevalence of CKD in the elderly person became eligible for government wel- There is a high prevalence of CKD in the fare benefits[1] .