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Comment & Response
December 28, 2021

Risks of Changing Estimated Glomerular Filtration Rate Thresholds in Older Persons—Reply

Author Affiliations
  • 1Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  • 2Alberta Health Services, Calgary, Alberta, Canada
JAMA Intern Med. 2022;182(2):239. doi:10.1001/jamainternmed.2021.7347

In Reply Criteria used to define chronic kidney disease (CKD) are based on the distribution of estimated glomerular filtration rate (eGFR) in a representative sample of healthy individuals and on the higher hazard rates of kidney failure and death in people with lower eGFRs or more severe albuminuria.1 Below an eGFR threshold of 60 mL/min/1.73 m2, relative rates of these adverse events become higher as eGFR declines, regardless of age. However, people 65 years or older with normal or mild albuminuria and an eGFR of 45 to 59 mL/min/1.73 m2 have a similar absolute risk of kidney failure and death as people of similar age with albuminuria and an eGFR of 60 to 89 mL/min/1.73 m2.

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