Rapid decline in kidney function was defined as a decline in the estimated glomerular filtration rate (eGFR) of > 3 mL/min/1.73 m2/year. Rapid deterioration of HRQOL was defined a change in the HRQOL value greater than the median. Among 970 patients, 360 (37.1%) were in the rapid kidney function decline group.
The damage can happen quickly – when it's caused by injury or toxins – or, more commonly, over months or years. High blood pressure (hypertension) and diabetes are the two most common causes of chronic kidney disease.
Kidney Disease: Improving Global Outcomes (KDIGO) guidelines define rapid progression as rate of eGFR declines > 5 mL/min per 1.73m2 per year [1, 2].
A GFR of 60 or higher is in the normal range. A GFR below 60 may mean kidney disease. A GFR of 15 or lower may mean kidney failure.
The average drop in the estimated glomerular filtration rate (eGFR) is about 1 cc per minute per 1.73 meters squared per year just on the basis of natural aging. Patients with some forms of kidney disease such as diabetes and glomerulonephritis can drop by 5 to 10 per year.
Kidney disease progresses at different rates for different people, and it can take between two and five years to pass between different stages. Kidney disease stages are measured by using a blood test to check the estimated glomerular filtration rate (eGFR).
Glomerular filtration rate (GFR) declines with age by approx. 1 ml/min/m2 per year beginning in the third decade of life. At 70 years of age > 40 ml/min/m2 of GFR will be lost.
In the general population, approximately 38% of adults aged 70 or older have an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, with most having moderate reductions in eGFR in the 30-59 ml/min/1.73 m2 range (1).
While it's not possible to reverse kidney damage, you can take steps to slow it down. Taking prescribed medicine, being physically active, and eating well will help.
At 40% function, you have Stage 3 chronic kidney disease (CKD). I recommend that you follow with your physician on a regular basis. You should follow a low salt diet as you mention. Your blood pressure should be controlled into the target range as suggested by your physician.
For a 60-year-old man, stage 1 kidney disease life expectancy will be approximately 15 years. That figure falls to 13 years, 8 years, and 6 years in the second, third, and fourth stages of kidney disease respectively.
The good news is that the right treatment and early detection can increase the function of your kidneys. One of the most common causes of decreased kidney function in elderly patients is diabetes. Diabetes can cause damage to the kidney's nerves and blood vessels even if your diabetes is well controlled.
A decrease or decline in the GFR implies progression of underlying kidney disease or the occurrence of a superimposed insult to the kidneys. This is most commonly due to problems such as dehydration and volume loss. An improvement in the GFR may indicate that the kidneys are recovering some of their function.
Don't eat ham, bacon, sausage, hot dogs, lunch meats, chicken tenders or nuggets, or regular canned soup. Only eat reduced-sodium soups that don't have potassium chloride as an ingredient (check the food label.) Also, only eat 1 cup, not the whole can.
An eGFR below 60 for three months or more, or an eGFR above 60 with kidney damage (marked by high levels of albumin in your urine) means chronic kidney disease. Your healthcare team will want to find the cause of your kidney disease and continue to check your kidney function to help plan your treatment.
Stage 5 (eGFR below 15) is a sign of kidney failure. It means you have less than 15% kidney function. This stage is the most serious and can be life-threatening. You will need dialysis (a machine to filter your blood) or a kidney transplant.
The estimated glomerular filtration rate (eGFR) is variable and it relies on a blood test, which may have day to day variations and it is an "estimation". Hence, the more times you do the test, the more accurate will be the estimate.
The health implications of chronic kidney disease will also depend on how healthy someone is otherwise. For that reason, doctors also look into conditions that may make chronic kidney disease get worse faster – including heart disease, poorly regulated high blood pressure or diabetes.
Patients may experience a wide variety of symptoms as kidney failure progresses. These include fatigue, drowsiness, decrease in urination or inability to urinate, dry skin, itchy skin, headache, weight loss, nausea, bone pain, skin and nail changes and easy bruising.
The most common causes of ESRD in the United States are diabetes and high blood pressure. These conditions can affect your kidneys. ESRD almost always comes after chronic kidney disease. The kidneys may slowly stop working during a period of 10 to 20 years before end-stage disease results.
Following the classical way, we can assert that normal GFR values are largely over 60 mL/min/1.73 m2 in healthy subjects, at least before the age of 70 years. However, we know that GFR physiologically decreases with age, and in adults older than 70 years, values below 60 mL/min/1.73 m2 could be considered normal.
Life Expectancy of Elderly Adults on Dialysis
Kidney dialysis life expectancy in the elderly depends on other medical conditions and how well they follow their treatment plan. The average life expectancy is 5-10 years but many live on dialysis for 20 or 30 years.